Outcome prediction in critically ill newborn using two scoring systems

Giriş

Beside Apgar Score (AS), the oldest scoring system used in neonatology, several scoring systems recently have been developed: Clinical Risk Index for Babies (CRIB), Score for Neonatal Acute Physiology (SNAP), Neonatal Therapeutic Intervention Scoring System (NTISS) etc.

Amaç

To evaluate the ability of 2 scoring systems in predieting neonatal mortality in very low birth weight (VLBW) newborns. Settings: Pediatric intensive çare unit (PICU) at Institute for Child's and Youth's Healthcare, Novi Sad, Yugoslavia.

Yöntem Retrospective analysis of 120 records of VLBW newliorn.s who were admittecl to PICU within 13 months. Both score systems were applied on each child. The area under receiver operating characleristics (ROC) curves was used for comparison.

Bulgular

Of 120 VLBW newborns, 88 (73.34 %) survived. Mean (SD) gestational age (GA) was 27.4 (2.5) weeks and BW was 1030g (351). Mean AS at 1. minute was 6,01 and at 5. minute 7,80. Significant dif-t'erence couldn't be found between the areas under ROC curves of AS 1 (0,807) and of AS 5 (0,789). 5 point AS Y value was optimal from the aspect of sensitivity (78.1) and specificity (70.5). 7 point AS 5 value was optimal from the aspect of sensitivity (68.7) and specificity (73-9). The CRIB had significantly greater the area under the ROC curve (0.972) than AS. 6 point CRIB value was optimal from the aspect of sensitivity (100.0) and specificity (87.5).

Sonuç

We found that CRIB has excellent predictive ability. CRIB predicted neonatal moıtality significantly better than AS.

Anahtar Kelimeler

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