CRIB II 评分与灌注指数对早产儿疾病严重程度评估的预测价值及相关性：一项观察性研究。
Predictive values and correlation of CRIB Score II and perfusion index in assessment of severity of illness in sick preterm neonates: An observational study.
机构信息
Department of Pediatrics, Uttar Pradesh University of Medical Sciences, Saifai, India.
Department of Pediatrics, King George Medical University, Lucknow, India.
出版信息
J Neonatal Perinatal Med. 2024;17(5):723-730. doi: 10.3233/NPM-240084.
BACKGROUND
Perfusion index (PI) and CRIB (Clinical risk index of babies) Score II both are minimally invasive tools for prediction of mortality and morbidity in sick neonates. This study aims to know the predictive values of both PI and CRIB Score II in assessment of severity of illness in preterm neonates of 28 to 32 weeks and their correlation.
METHODS
PI and CRIB II Score of 125 sick preterm neonates admitted in NICU were assessed within 12 hours of admission. Severity noted in form of outcome. Correlation between PI and CRIB Score II were observed.
RESULTS
Receiver operating characteristic (ROC) curve were plotted for PI and CIRB Score II with outcome (discharged vs expired). Area under curve for perfusion index was 0.776 at 95% confidence interval. Optimum cutoff point based on ROC curve was 1.65 with sensitivity of 84%., specificity of 37.2% with positive predictive value of 70% and negative predictive value of 57%. Area under curve for CRIB Score II was 0.622 (p value < 0.028), optimum cut off point based on ROC curve for CRIB II score was 3.5 with sensitivity 79.10% of specificity of 40% positive predictive value is 43.03% and negative predictive value of 76.9%. Spearman's correlation coefficient between PI and CRIB II score was -0.272 and p value is 0.002.
CONCLUSION
This study concluded that perfusion index (p < 0.001) is better for predicting the severity compared to CRIB II score (p < 0.028). A weak negative correlation exists between PI and CRIB II score (r = -0.272).
背景
灌注指数（PI）和 CRIB（婴儿临床风险指数）评分 II 均为预测患病新生儿死亡率和发病率的微创工具。本研究旨在了解 PI 和 CRIB 评分 II 在评估 28 至 32 周早产儿疾病严重程度方面的预测值及其相关性。
方法
在入住 NICU 的 125 名患病早产儿入院后 12 小时内评估 PI 和 CRIB II 评分。以结局形式记录严重程度。观察 PI 和 CRIB 评分 II 之间的相关性。
结果
绘制了 PI 和 CIRB 评分 II 与结局（出院与死亡）的受试者工作特征（ROC）曲线。灌注指数的曲线下面积为 0.776，置信区间为 95%。基于 ROC 曲线的最佳截断点为 1.65，灵敏度为 84%，特异性为 37.2%，阳性预测值为 70%，阴性预测值为 57%。CRIB 评分 II 的曲线下面积为 0.622（p 值<0.028），基于 ROC 曲线的 CRIB II 评分最佳截断点为 3.5，灵敏度为 79.10%，特异性为 40%，阳性预测值为 43.03%，阴性预测值为 76.9%。PI 和 CRIB II 评分之间的斯皮尔曼相关系数为-0.272，p 值为 0.002。
结论
本研究得出结论，与 CRIB II 评分（p<0.028）相比，灌注指数（p<0.001）更能预测疾病的严重程度。PI 和 CRIB II 评分之间存在微弱的负相关（r=-0.272）。
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