临床婴儿风险指数对于预测新生儿死亡率的重要性。

Importance Of Clinical Risk Index For Babies Score For Predicting Mortality Among Neonates.

机构信息

Department of Paediatrics, Ayub Medical College, Abbottabad, Pakistan.

Islamabad Medical and Dental College, Islamabad, Pakistan.

出版信息

J Ayub Med Coll Abbottabad. 2020 Oct-Dec;32(4):502-506.

PMID:33225652

Abstract

BACKGROUND

High mortality among premature and very low birth weight (VLBW) babies necessitates the need to formulate and use scoring systems like CRIB score to predict the mortality in this vulnerable group. Objective of the study was to determine the strength of Clinical Risk Index For Babies (CRIB) score in detecting neonatal mortality in babies presenting with very low birth weight so that timely intervention can be done. It was a cross-sectional study, conducted at NICU, Children Hospital, Pakistan Institute of Medical Sciences Islamabad (PIMS) in nine months starting from First July 2017.

METHODS

A total of two hundred and fifty-four (n=254) new-borns with birth weight of between 500-1500 grams and gestational age lesser than 35 weeks were included in the study. CRIB score was calculated in all neonates and its association was assessed with mortality during NICU stay. Recorded data was analysed for demographic variables. Means and standard deviation was calculated for numeric variables. Chi-square test was applied to find p-value for the correlation between the main variables.

RESULTS

54.3% (n=138) patients were males and 45.7% (n=116) were females. Mean gestational age was 33.3 weeks±1.04 SD and mean birth weight of study population was 1129.9 grams±210.6 SD. Mean CRIB score among the study population was 6.3±3.1SD and overall mortality was found to be 54.7% (n=139). Mean CRIB score was found to be 8.27±2.1 SD among mortality group and it was 3.87±3.4 SD among newborns who were discharged (p<0.05). Mortality was present in 4.3% (n=4) of neonates with CRIB score between 1 to 5, 87.1% (n=121) who had CRIB score between 6 to 10 and 100% (n=14) of neonates who had CRIB score level 11-15 (p<0.05), so a significantly higher percentage mortality was noted among neonates with higher CRIB scores.

CONCLUSIONS

According to our study mean CRIB score is a significant predictor of neonatal mortality.

摘要

背景

早产儿和极低出生体重（VLBW）婴儿的高死亡率需要制定和使用评分系统，如 CRIB 评分，以预测这一脆弱群体的死亡率。本研究的目的是确定婴儿临床风险指数（CRIB）评分在检测极低出生体重婴儿的新生儿死亡率方面的强度，以便及时进行干预。这是一项在巴基斯坦伊斯兰堡巴基斯坦医学科学院儿童医院新生儿重症监护病房（NICU）进行的横断面研究，从 2017 年 7 月 1 日开始，历时 9 个月。

方法

共纳入 254 名（n=254）出生体重在 500-1500 克之间、胎龄小于 35 周的新生儿。对所有新生儿计算 CRIB 评分，并评估其与 NICU 住院期间死亡率的关系。记录的数据用于分析人口统计学变量。数值变量的均值和标准差。应用卡方检验评估主要变量之间的相关性。

结果

54.3%（n=138）为男性，45.7%（n=116）为女性。平均胎龄为 33.3 周±1.04 标准差，研究人群的平均出生体重为 1129.9 克±210.6 标准差。研究人群的平均 CRIB 评分为 6.3±3.1 标准差，总死亡率为 54.7%（n=139）。死亡组的平均 CRIB 评分（n=139）为 8.27±2.1 标准差，出院组的平均 CRIB 评分（n=116）为 3.87±3.4 标准差（p<0.05）。CRIB 评分为 1-5 的新生儿死亡率为 4.3%（n=4），CRIB 评分为 6-10 的新生儿死亡率为 87.1%（n=121），CRIB 评分为 11-15 的新生儿死亡率为 100%（n=14）（p<0.05），因此，CRIB 评分较高的新生儿死亡率明显较高。