Matsuoka O T, Sadeck L S, Haber J F, Proença R S, Mataloun M M, Ramos J L, Leone C R
Instituto da Criança Prof. Pedro de Alcântara, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), Brasil.
Rev Saude Publica. 1998 Dec;32(6):550-5. doi: 10.1590/s0034-89101998000600008.
Several indicators, mainly birthweight and gestational age, have been used to predict the mortality risk in neonatal intensive care units. In order to assess the potential value of CRIB in predicting neonatal mortality, the score was used over the first 12 hours of life of the newborns admitted to this unit, during the year of 1996.
The inclusion criteria consisted of all infants without inevitably lethal congenital malformations, birthweight below 1,500 g and/or gestational age less than 31 weeks. Newborn children who died within 12 hours after delivery were excluded. The CRIB score covers birth weight, gestational age, the presence of congenital malformations (not inevitably lethal) and three indexes of physiological status during first 12 hours after birth-maximum and minimum appropriate fraction of inspired oxygen and maximum (most acidotic) base excess.
In a prospective cohort, seventy one newborn children were studied. The birthweight (average) was 1,119 +/- 275.6 g, gestational age 30 weeks 4/7 +/- 2 weeks 3/7; male (57%); Apgar 1(0) min. score < or = 3 (36.2%) and Apgar 5 degrees min. score < 5 (5.8%). The mortality rate was 29.6% (gold standard). But mortality rate by birthweight less than 1,000 gr. or gestational age lower than 29 weeks was 60.0% and for the CRIB score above 10 was 100%.
The specificity and predictive positive values for CRIB score above 10 were greater than any other two parameters. The area under the receiver operating characteristic (ROC) curve for predicting death was significantly greater for CRIB than for birthweight alone. It was concluded that the CRIB score is a better predictive indicator for mortality than are birthweight and gestational age.
主要包括出生体重和胎龄在内的多个指标已被用于预测新生儿重症监护病房的死亡风险。为了评估CRIB评分在预测新生儿死亡方面的潜在价值，1996年对该病房收治的新生儿出生后最初12小时内使用了该评分。
纳入标准包括所有无不可避免的致命性先天性畸形、出生体重低于1500克和/或胎龄小于31周的婴儿。排除出生后12小时内死亡的新生儿。CRIB评分涵盖出生体重、胎龄、先天性畸形（非不可避免的致命性）的存在情况以及出生后最初12小时内的三个生理状态指标——吸入氧的最大和最小适宜分数以及最大（最酸中毒）碱剩余。
在一个前瞻性队列中，对71名新生儿进行了研究。出生体重（平均）为1119±275.6克，胎龄30周4/7±2周3/7；男性（57%）；阿氏评分1（0）分钟<或=3（36.2%），阿氏评分5分钟<5（5.8%）。死亡率为29.6%（金标准）。但出生体重小于1000克或胎龄低于29周的死亡率为60.0%，CRIB评分高于10的死亡率为100%。
CRIB评分高于10的特异性和预测阳性值大于任何其他两个参数。预测死亡的受试者工作特征（ROC）曲线下面积，CRIB评分显著大于仅出生体重。得出结论，CRIB评分比出生体重和胎龄是更好的死亡预测指标。
