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Objective <p>To develop and internally validate a model predicting neonatal mortality in infants with neonatal encephalopathy requiring therapeutic hypothermia (TH), using national data.</p> Study design <p>Data from 385 infants treated with TH across 19 hospitals (2016–2021) were analysed. Multivariable logistic regression with backward stepwise selection was applied. Discrimination was assessed using the C-statistic, with internal validation by bootstrapping. The THERM (Therapeutic Hypothermia Early Risk Model for Mortality) tool was developed to calculate individualised mortality risk.</p> Results <p>Forty-six infants (11.9%) died within 28 days. Four predictors were retained: prelabour Caesarean section, adrenaline use, base excess ≤–22 mmol/L, and seizures during the first day of life. The model demonstrated excellent discrimination [optimism-adjusted C-statistic 0.885 (95% CI: 0.827–0.936)].</p> Conclusions <p>Four routinely collected variables predicted mortality in infants undergoing TH. The THERM tool provides a practical resource for clinicians, enabling personalised risk assessment and supporting parental counselling during the first day of life.</p>

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Development of a prediction model for mortality in infants undergoing therapeutic hypothermia for neonatal encephalopathy

  • 期刊论文

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  • 发表日期：

    2026年1月5日

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  • Jill M. Mitchell,
  • Clare L. Rodrigues,
  • Margo Dunworth,
  • Julie Mc Ginley,
  • Laura O’Byrne,
  • Roisin Hall,
  • Paul Corcoran,
  • Indra San Lazaro Campillo,
  • Peter Mc Kenna,
  • John R. Higgins,
  • Joye McKernan,
  • Ali S. Khashan,
  • Gillian M. Maher,
  • John Murphy,
  • Brian H. Walsh,
  • Richard A. Greene,
  • Fergus P. McCarthy

摘要

Objective

To develop and internally validate a model predicting neonatal mortality in infants with neonatal encephalopathy requiring therapeutic hypothermia (TH), using national data.

Study design

Data from 385 infants treated with TH across 19 hospitals (2016–2021) were analysed. Multivariable logistic regression with backward stepwise selection was applied. Discrimination was assessed using the C-statistic, with internal validation by bootstrapping. The THERM (Therapeutic Hypothermia Early Risk Model for Mortality) tool was developed to calculate individualised mortality risk.

Results

Forty-six infants (11.9%) died within 28 days. Four predictors were retained: prelabour Caesarean section, adrenaline use, base excess ≤–22 mmol/L, and seizures during the first day of life. The model demonstrated excellent discrimination [optimism-adjusted C-statistic 0.885 (95% CI: 0.827–0.936)].

Conclusions

Four routinely collected variables predicted mortality in infants undergoing TH. The THERM tool provides a practical resource for clinicians, enabling personalised risk assessment and supporting parental counselling during the first day of life.