Marete I K, Wasunna A O, Otieno P A
East Afr Med J. 2011 Jan;88(1):18-23.
Neonatal deaths, especially among the Low Birth Weight (LBW) babies, are of major concern in the Newborn Unit (NBU) of Kenyatta National Hospital (KNH). Several instruments have been developed to predict initial mortality risk among the LBW babies. Among them is the scoring system Clinical Risk Index for Babies also known as CRIB II score.
To evaluate the use of CRIB II score as a tool to predict the risk for neonatal mortality among the LBW babies at KNH.
A prospective cohort study.
Newborn Unit of Kenyatta National Hospital.
A total sample of 135 low birthweight babies were followed up from admission till discharge, the 28th day of life or death whichever came first.
One hundred and thirty five newborns were enrolled into the study. Birth weight ranged from 600-2500 g, with a median of 1600g. Total CRIB II score ranged from 1-15, with a median of 5.5. Gestational age ranged from 26 - 38 weeks. Total mortality was 45.9%. Birth weight < 1500 g, gestational age < 30 weeks, base excess <-12 mmol/l, temperature at admission > 37.5 or < 35 (all components of CRIB II) and total CRIB II score of > 4 were all found to be significantly associated with hospital neonatal mortality. Using a cut off point of 4, CRIB II score was found to have a sensitivity of 80.6%, specificity of 75.3%, and a predictive value of 77.7% compared to 72.5, 71.2, and 71.8% respectively for birthweight. Gestational age was found to have even lower figures; 56, 75 and 66% for sensitivity, specificity and predictive values respectively.
CRIB II score of > 4 was found to have better prediction for mortality among the LBW babies at KNH-NBU compared to the traditionally used predictors and can be used to prioritise care for such neonates for better outcome.
新生儿死亡，尤其是低出生体重（LBW）婴儿的死亡，是肯雅塔国家医院（KNH）新生儿病房（NBU）主要关注的问题。已经开发了几种工具来预测低出生体重婴儿的初始死亡风险。其中包括临床风险指数评分系统，也称为CRIB II评分。
评估CRIB II评分作为预测KNH低出生体重婴儿新生儿死亡风险工具的应用。
一项前瞻性队列研究。
肯雅塔国家医院新生儿病房。
共135例低出生体重婴儿从入院直至出院、出生后第28天或死亡（以先到者为准）进行随访。
135例新生儿纳入研究。出生体重范围为600 - 2500克，中位数为1600克。CRIB II总分范围为1 - 15分，中位数为5.5分。胎龄范围为26 - 38周。总死亡率为45.9%。出生体重<1500克、胎龄<30周、碱剩余<-12 mmol/l、入院时体温>37.5或<35（CRIB II的所有组成部分）以及CRIB II总分>4均被发现与医院新生儿死亡率显著相关。使用4分作为临界值，发现CRIB II评分的敏感性为80.6%，特异性为75.3%，预测值为77.7%，相比之下，出生体重的相应数值分别为72.5%、71.2%和71.8%。发现胎龄的相应数值更低；敏感性、特异性和预测值分别为56%、75%和66%。
与传统使用的预测指标相比，发现CRIB II评分>4对KNH - NBU的低出生体重婴儿死亡率有更好的预测作用，可用于为此类新生儿优先安排护理以获得更好的结局。
