Özalkaya Elif, Arifoğlu İlter, Yarış Emre, Topcuoğlu Sevilay, Sancak Selim, Dinçer Emre, Alkan Özge Yatır, Karatekin Güner
University of Health Sciences, Faculty of Medicine, Zeynep Kamil Maternity and Children's Training and Research Hospital, Department of Pediatrics, Division of Neonatology, Istanbul, 34668, Turkey.
BMC Pediatr. 2025 Apr 23;25(1):317. doi: 10.1186/s12887-025-05638-0.
The aim of this study is to evaluate the predictive value of the vasoactive inotropic score (VIS) for mortality in extremely low birth weight (ELBW) preterm infants and to compare this value with the well-known Clinical Risk Index for Babies-II (CRIB-II) score.
This study was designed as a retrospective study. A total of 280 preterm infants weighing under 1000 g who were admitted to the neonatal intensive care unit over a five-year period were included in the study. For each patient, a CRIB-II score and VIS were calculated, and their ability to predict mortality was compared. To predict and compare the accuracy of the scoring systems, Receiver Operating Characteristic (ROC) analysis was used, and the area under the curve (AUC) was calculated.
In infants who died within the first 28 days after birth, the CRIB-II score (p < 0.001) and VISmax (p < 0.001) were higher compared with those who survived. The AUCs for the CRIB-II score and VIS in predicting mortality were 0.86/0.81, with cut-offs of > 12/ > 5, sensitivities of 79/70, specificities of 82/87, positive predictive values (PPVs) of 81/85, and negative predictive values (NPVs) of 80/75. There were no statistically significant differences between the AUC values of the CRIB-II score and VIS variables (p = 0.160).
The VIS can predict mortality in ELBW preterm infants as accurately as the CRIB-II score can.
本研究旨在评估血管活性药物评分（VIS）对极低出生体重（ELBW）早产儿死亡率的预测价值，并将该值与广为人知的婴儿临床风险指数-II（CRIB-II）评分进行比较。
本研究设计为回顾性研究。研究纳入了在五年期间入住新生儿重症监护病房的280名体重低于1000g的早产儿。为每位患者计算CRIB-II评分和VIS，并比较它们预测死亡率的能力。为了预测和比较评分系统的准确性，使用了受试者工作特征（ROC）分析，并计算了曲线下面积（AUC）。
出生后28天内死亡的婴儿，其CRIB-II评分（p < 0.001）和最大VIS（VISmax，p < 0.001）高于存活婴儿。CRIB-II评分和VIS预测死亡率的AUC分别为0.86/0.81，临界值分别为>12/>5，敏感性分别为79/70，特异性分别为82/87，阳性预测值（PPV）分别为81/85，阴性预测值（NPV）分别为80/75。CRIB-II评分和VIS变量的AUC值之间无统计学显著差异（p = 0.160）。
VIS预测ELBW早产儿死亡率的准确性与CRIB-II评分相当。
