Accepted for/Published in: JMIR Pediatrics and Parenting
Date Submitted: Jul 5, 2023
Date Accepted: Dec 5, 2023
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The Finnegan score for neonatal opioid withdrawal revisited by routine electronic data: a retrospective study
ABSTRACT
Background:
The severity of the neonatal abstinence syndrome (NAS) may be assessed by the Finnegan score (FS). Since the FS is laborious and subjective, alternative ways of assessment may improve quality of care.
Objective:
In this pilot study, we examined associations between the FS and routine monitoring data obtained from the electronic health record system.
Methods:
he study included 193 neonates with NAS after intrauterine (n=16) or postnatal opioid exposure (n=177). Routine monitoring data were analyzed at 60 ± 10 min (t–1) and 120 ± 10 min (t–2) before each FS assessment. Within each time period, the mean for each variable was calculated. Readings were also normalized to individual baseline data calculated per patient and parameter. Mixed effects models were applied to assess the effect of the different variables.
Results:
Plots of vital parameters against the FS showed heavily scattered data. When controlling for several variables, the best-performing mixed effects model displayed significant effects of individual baseline-controlled mean heart rate (estimate: 0.04; 95%-CI 0.02-0.07) and arterial blood pressure (estimate: 0.06; 95%-CI 0.02-0.09) at t–1 with R2m = 0.11 as goodness of fit.
Conclusions:
Routine electronic data can be extracted and analyzed for correlation with FS data. Mixed effects models show small but significant effects after normalizing vital parameters to individual baselines. Clinical Trial: N/A. The institutional review board of the Charité – Universitätsmedizin Berlin approved the study (EA2/104/21).
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