Akhter M, Shahidullah M, Mannan M A, Dey S K, Jahan I, Moni S C, Shabuj M K, Rahman T, Rumman M, Begum B
Dr Mohosina Akhter, Assistant Professor, Department of Neonatology, Mymensingh Medical College, Mymensingh, Bangladesh; E-mail:
Mymensingh Med J. 2021 Jul;30(3):601-608.
Clinical risk index for babies II (CRIB II) score is simple, validated and widely used risk-adjustment instrument for predicting mortality among preterm low birth weight babies. To assess the efficacy of CRIB II score as a tool to predict the risk for neonatal death among the preterm and LBW babies admitted in NICU of BSMMU, a tertiary care hospital in Bangladesh. This prospective observational study was conducted in Department of Neonatology in BSMMU from September 2016 to August 2017. Inborn preterm neonates with gestational age ≤34 weeks admitted were enrolled in the study. CRIB-II score was calculated for each infant within 1 hour of birth from birth weight, gestational age, sex, admission temperature and base excess. The primary outcome measured in the study was neonatal death or survival up to 28 days. Total 112 patients were finally analyzed in this study. Mean CRIB II score was significantly higher in the non-survivor group compared to the survivor group (p-value <0.0001). Receiver operating characteristic (ROC) curve analysis for mortality prediction by CRIB II score, gestational age and birth weight showed AUC 0.87 (95% CI 0.76-0.97), 0.76 (95% CI 0.63-0.88) and 0.79 (95% CI 0.66-0.92) respectively. ROC curve analysis also revealed that the most suitable cut-off points for predicting mortality were 5 for CRIB II score, 32 weeks for gestational age and 1250 gram for birth weight. Using these most suitable cut-off points, CRIB II score had the highest sensitivity and specificity followed by birth weight and gestational age. In this study, CRIB II score was found to be an effective tool for predicting neonatal death among preterm LBW babies. It predicted outcome more accurately than birth weight or gestational age alone.
婴儿临床风险指数II（CRIB II）评分是一种简单、经过验证且广泛应用的风险调整工具，用于预测早产低体重婴儿的死亡率。为了评估CRIB II评分作为预测孟加拉国一家三级护理医院BSMMU新生儿重症监护病房（NICU）收治的早产和低体重婴儿新生儿死亡风险工具的有效性。这项前瞻性观察研究于2016年9月至2017年8月在BSMMU新生儿科进行。纳入研究的是胎龄≤34周的出生时即早产的新生儿。在出生后1小时内根据出生体重、胎龄、性别、入院体温和碱剩余为每个婴儿计算CRIB-II评分。该研究测量的主要结局是新生儿死亡或存活至28天。本研究最终共分析了112例患者。非存活组的平均CRIB II评分显著高于存活组（p值<0.0001）。通过CRIB II评分、胎龄和出生体重预测死亡率的受试者工作特征（ROC）曲线分析显示，AUC分别为0.87（95%CI 0.76-0.97）、0.76（95%CI 0.63-0.88）和0.79（95%CI 0.
