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Article: Refining the Apgar score cut-off point for newborns at risk

TitleRefining the Apgar score cut-off point for newborns at risk
Authors
KeywordsApgar score
Birth register
Mortality
Neonatal
ROC curve
Issue Date2004
PublisherBlackwell Publishing Ltd. The Journal's web site is located at http://www.blackwellpublishing.com/journal.asp?ref=1328-8067&site=1
Citation
Acta Paediatrica, International Journal Of Paediatrics, 2004, v. 93 n. 1, p. 53-59 How to Cite?
AbstractAim: To evaluate the Apgar score predictive power for mortality during different periods in the first year of life in a population with a very low mortality rate. Methods: The records of all singleton live births without severe congenital malformations and length of gestation >25 wk (n = 976635) were collected from the Swedish Medical Birth Registry, 1990 to 1998. Receiver operating characteristic (ROC) analysis was utilized. Results: Both the 1-min and the 5-min Apgar scores were shown to be good discriminators for early mortality, with the area under the ROC curve >0.85. For babies at risk of early death, the selected cut-off values for the 1-min Apgar score was <8 for preterm (true-positive (TP) rate: 83.9%; false-positive (FP) rate: 17.7%) and term babies (TP rate: 69.4%; FP rate: 6.7%). At 5 min, the analysis revealed that newborns with an Apgar score <9 were at risk for early death (preterm babies: TP rate: 79.8%; FP rate: 13.3%; term babies: TP rate: 73.8%; FP rate: 3.4%). Conclusions: Our analysis did not support the common practice in the clinic or in research of grouping infants at risk in Apgar score groups, i.e. a score below 4 or a score below 7. However, the data presented here allow the clinicians and researchers to identify and define a suitable cut-off point in relation to the quality of neonatal care and resources available, rather than adhering to a historical cut-off value that has not been studied in depth.
Persistent Identifierhttp://hdl.handle.net/10722/87640
ISSN
2015 Impact Factor: 1.647
2015 SCImago Journal Rankings: 0.794
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorChong, DSYen_HK
dc.contributor.authorKarlberg, Jen_HK
dc.date.accessioned2010-09-06T09:32:26Z-
dc.date.available2010-09-06T09:32:26Z-
dc.date.issued2004en_HK
dc.identifier.citationActa Paediatrica, International Journal Of Paediatrics, 2004, v. 93 n. 1, p. 53-59en_HK
dc.identifier.issn0803-5253en_HK
dc.identifier.urihttp://hdl.handle.net/10722/87640-
dc.description.abstractAim: To evaluate the Apgar score predictive power for mortality during different periods in the first year of life in a population with a very low mortality rate. Methods: The records of all singleton live births without severe congenital malformations and length of gestation >25 wk (n = 976635) were collected from the Swedish Medical Birth Registry, 1990 to 1998. Receiver operating characteristic (ROC) analysis was utilized. Results: Both the 1-min and the 5-min Apgar scores were shown to be good discriminators for early mortality, with the area under the ROC curve >0.85. For babies at risk of early death, the selected cut-off values for the 1-min Apgar score was <8 for preterm (true-positive (TP) rate: 83.9%; false-positive (FP) rate: 17.7%) and term babies (TP rate: 69.4%; FP rate: 6.7%). At 5 min, the analysis revealed that newborns with an Apgar score <9 were at risk for early death (preterm babies: TP rate: 79.8%; FP rate: 13.3%; term babies: TP rate: 73.8%; FP rate: 3.4%). Conclusions: Our analysis did not support the common practice in the clinic or in research of grouping infants at risk in Apgar score groups, i.e. a score below 4 or a score below 7. However, the data presented here allow the clinicians and researchers to identify and define a suitable cut-off point in relation to the quality of neonatal care and resources available, rather than adhering to a historical cut-off value that has not been studied in depth.en_HK
dc.languageengen_HK
dc.publisherBlackwell Publishing Ltd. The Journal's web site is located at http://www.blackwellpublishing.com/journal.asp?ref=1328-8067&site=1en_HK
dc.relation.ispartofActa Paediatrica, International Journal of Paediatricsen_HK
dc.rightsActa Paediatrica. Copyright © Blackwell Publishing Ltd.en_HK
dc.subjectApgar scoreen_HK
dc.subjectBirth registeren_HK
dc.subjectMortalityen_HK
dc.subjectNeonatalen_HK
dc.subjectROC curveen_HK
dc.titleRefining the Apgar score cut-off point for newborns at risken_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0803-5253&volume=93&spage=53&epage=59&date=2004&atitle=Refining+the+Apgar+score+cut-off+point+for+newborns+at+risken_HK
dc.identifier.emailKarlberg, J: jpekarl@hkucc.hku.hken_HK
dc.identifier.authorityKarlberg, J=rp00400en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1080/08035250310007295en_HK
dc.identifier.pmid14989440-
dc.identifier.scopuseid_2-s2.0-1642537692en_HK
dc.identifier.hkuros85961en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-1642537692&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume93en_HK
dc.identifier.issue1en_HK
dc.identifier.spage53en_HK
dc.identifier.epage59en_HK
dc.identifier.isiWOS:000188515600012-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridChong, DSY=7005265413en_HK
dc.identifier.scopusauthoridKarlberg, J=7005218406en_HK

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