A multicenter study on the risk factors for in-hospital mortality in neonates with severe asphyxia at tertiary hospitals in Henan Province
- 1Department of Neonatology, Third Affiliated Hospital of Zhengzhou University/Maternal and Child Health Hospital of Henan Province, Zhengzhou 450052, China
Abstract
ObjectiveTo construct a risk prediction model for in-hospital mortality in neonates with severe asphyxia.MethodsA total of 836 neonates with severe asphyxia admitted to 20 tertiary hospitals in Henan Province between January 2022 and December 2025 were retrospectively enrolled and divided into a death group (n=267) and a survival group (n=569) according to outcome. Birth characteristics, resuscitation measures, and early complications were analyzed. Multivariable logistic regression was used to identify risk factors, and a nomogram prediction model was developed. Receiver operating characteristic curves, calibration curves, and decision curve analysis were used to evaluate the model's discrimination, calibration accuracy, and clinical applicability.ResultsMultivariable logistic regression showed that high lactate level, low birth weight, a 5-minute Apgar score of ≤5, use of epinephrine, volume expansion during resuscitation, persistent pulmonary hypertension of the newborn, pulmonary hemorrhage, shock, and grade III/IV intraventricular hemorrhage were independent risk factors for in-hospital mortality in neonates with severe asphyxia (P<0.05). The nomogram based on these risk factors yielded an area under the curve of 0.795 (95%CI: 0.762-0.827). Calibration and decision curve analyses indicated that the model had high accuracy and good clinical applicability.ConclusionsIn-hospital mortality among severely asphyxiated neonates is closely associated with birth weight, resuscitation modalities, and early complications such as pulmonary hemorrhage and shock. The risk model constructed based on these factors shows good predictive value.
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BibTeX
@article{wanjun2026multicenter,
title = {{A multicenter study on the risk factors for in-hospital mortality in neonates with severe asphyxia at tertiary hospitals in Henan Province}},
author = {PEI Wan-Jun and ZHANG Yan-Hua and LI Shu-Jin and ZHOU Bian-Sheng and CAO Ya-Qin and WANG Bao-Feng and LIU Qian and WANG Zhan-Sheng and GUO Hong-Xiang and SUN Jian-Wei and LI Li and FENG Min and WANG Xiao-Bing and ZHU Ping and TANG Cheng-He and KANG Le and ZHANG Shi-Chang and GUO Xiao-Yan and SHI Lei and YAN Feng-Lin and MENG Wei-Ling and CHEN Shu-Ping and XU Fa-Lin and DONG Hui-Fang},
journal = {中国当代儿科杂志},
year = {2026},
month = oct,
doi = {10.7499/j.issn.1008-8830.2606073},
url = {https://doi.org/10.7499/j.issn.1008-8830.2606073},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - A multicenter study on the risk factors for in-hospital mortality in neonates with severe asphyxia at tertiary hospitals in Henan Province
AU - PEI Wan-Jun
AU - ZHANG Yan-Hua
AU - LI Shu-Jin
AU - ZHOU Bian-Sheng
AU - CAO Ya-Qin
AU - WANG Bao-Feng
AU - LIU Qian
AU - WANG Zhan-Sheng
AU - GUO Hong-Xiang
AU - SUN Jian-Wei
AU - LI Li
AU - FENG Min
AU - WANG Xiao-Bing
AU - ZHU Ping
AU - TANG Cheng-He
AU - KANG Le
AU - ZHANG Shi-Chang
AU - GUO Xiao-Yan
AU - SHI Lei
AU - YAN Feng-Lin
AU - MENG Wei-Ling
AU - CHEN Shu-Ping
AU - XU Fa-Lin
AU - DONG Hui-Fang
PY - 2026
DA - 2026/10/23
JO - 中国当代儿科杂志
DO - 10.7499/j.issn.1008-8830.2606073
UR - https://doi.org/10.7499/j.issn.1008-8830.2606073
AB - ObjectiveTo construct a risk prediction model for in-hospital mortality in neonates with severe asphyxia.MethodsA total of 836 neonates with severe asphyxia admitted to 20 tertiary hospitals in Henan Province between January 2022 and December 2025 were retrospectively enrolled and divided into a death group (n=267) and a survival group (n=569) according to outcome. Birth characteristics, resuscitation measures, and early complications were analyzed. Multivariable logistic regression was used to identify risk factors, and a nomogram prediction model was developed. Receiver operating characteristic curves, calibration curves, and decision curve analysis were used to evaluate the model's discrimination, calibration accuracy, and clinical applicability.ResultsMultivariable logistic regression showed that high lactate level, low birth weight, a 5-minute Apgar score of ≤5, use of epinephrine, volume expansion during resuscitation, persistent pulmonary hypertension of the newborn, pulmonary hemorrhage, shock, and grade III/IV intraventricular hemorrhage were independent risk factors for in-hospital mortality in neonates with severe asphyxia (P<0.05). The nomogram based on these risk factors yielded an area under the curve of 0.795 (95%CI: 0.762-0.827). Calibration and decision curve analyses indicated that the model had high accuracy and good clinical applicability.ConclusionsIn-hospital mortality among severely asphyxiated neonates is closely associated with birth weight, resuscitation modalities, and early complications such as pulmonary hemorrhage and shock. The risk model constructed based on these factors shows good predictive value.
SN - 1008-8830
SN - 2096-9228
ER -