Louis et al identified risk factors for mortality in a neonate with the meconium aspiration syndrome. This can help to identify a patient who may benefit from more aggressive management or who may be greater risk for complications. The authors are from the Postgraduate Institute of Medical Education and Research (PGIMER) in Chandigarh, India.
Patient selection: neonate with meconium aspiration syndrome
Outcome: mortality
Predictors of mortality from multivariate logistic regression analysis:
(1) low birth weight (< 2,500 g, with odds of death decreasing by 20% from baseline for every 100 gram increase in birth weight)
(2) initial oxygen requirement (FIO2) in percent
(3) myocardial dysfunction
Additional associations from the univariate analysis (Table I):
(1) renal dysfunction
(2) seizure
(3) hypoxic ischemic encephalopathy
(4) persistent pulmonary hypertension
(5) need for mechanical ventilation
(6) low Apgar scores (at 1 and 5 minutes) and nonvigorous at birth
(7) low cord pH
(8) female gender
(9) hypotensive shock
(10) small for gestational age (intra-uterine growth retardation, IUGR)
