University Clinic for Gynecology and Obstetrics, Medical Faculty Skopje, Skopje, RN Macedoniaa.
Institute for Epidemiology and Biostatistics, Medical Faculty Skopje, Skopje, RN Macedonia.
Pril (Makedon Akad Nauk Umet Odd Med Nauki). 2020 Dec 8;41(3):59-64. doi: 10.2478/prilozi-2020-0046.
Predicting the outcome of neonatal critical patients remains elusive. The multiple factors of maternal state of health (infections, diabetes, gestosis), the placental situation (premature rupture of membranes) as well as multiple factors from the baby (small for gestational age, low Apgar score, low birth infections, mechanical ventilation, hypoglycaemia hyperglycamiea) render the approach to treatment of each patient individual and the outcome uncertain. Several approaches and scales are developed in order to assess the mortality risk in those rather complicated situations.We used the CRIB-II scale to assess the mortality risk in 80 patients delivered in a large tertiary level hospital with more than 4,000 deliveries yearly. The patients were stratified according to all the neonatal risk factors and comorbidities. The CRIB-II scale identified well the mortality rates, but not the outcomes. A large and well-balanced cohort of patients followed for a longer period is required to discern in detail the importance of CRIB-II scale in predicting outcomes in high-risk new-borns. This could serve as an assistance to personalized approach to severely sick children. In addition, it is a valuable method in comparing outcomes in different NICUs and outcomes in different times in the same NICU, thus rendering possible improvements in the same unit and among several NICU departments.
预测新生儿重症患者的预后仍然难以捉摸。产妇健康状况的多种因素（感染、糖尿病、妊娠毒血症）、胎盘情况（胎膜早破）以及婴儿的多种因素（小于胎龄儿、低 Apgar 评分、低出生感染、机械通气、低血糖高血糖）使得对每位患者的治疗方法和结果不确定。已经开发了几种方法和评分来评估这些复杂情况下的死亡率风险。
我们使用 CRIB-II 评分评估了在一家每年有超过 4000 次分娩的大型三级医院分娩的 80 名患者的死亡风险。根据所有新生儿风险因素和合并症对患者进行分层。CRIB-II 评分很好地识别了死亡率，但不能识别结局。需要一个更大、更平衡的患者队列，并进行更长时间的随访，才能详细了解 CRIB-II 评分在预测高危新生儿结局中的重要性。这可以作为个性化治疗严重患病儿童的辅助手段。此外，它是比较不同 NICU 之间的结局以及同一 NICU 不同时间的结局的一种有价值的方法，从而有可能在同一单位和多个 NICU 部门进行改进。
