Akhila Goolla, Choudhury Jasashree, Krishnegowda Vijay Kumar, Nanda Debasish
Department of Pediatrics, IMS and SUM Hospital, Bhubaneswar, Odisha, India.
Department of Neonatology, IMS and SUM Hospital, Bhubaneswar, Odisha, 751003, India.
Indian Pediatr. 2025 May 28. doi: 10.1007/s13312-025-00107-4.
To compare Clinical Risk Index for Babies (CRIB) II score and Extended Sick Neonatal Score (ESNS) for predicting in-hospital mortality in premature neonates with gestational age ≤ 32 weeks.
This prospective observational study included 110 preterm neonates less than equal to 32 weeks of gestation. Clinical parameters of CRIB II score and ESNS were documented at time of admission and laboratory parameter were obtained with 24 h. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and likelihood ratio of the two scores as a predictor of mortality were compared.
The sensitivity, specificity, PPV, NPV and the Area under the Receiver Operating Characteristic (ROC) curve of CRIB II score at a cut-off value of ≥ 10 were 85.2%, 96.4%, 88.5%, 95.2%, ands 0.91 (95%CI 0.83, 0.98) respectively. The corresponding values for ESNS at a cut-off value of ≤ 11, were 77.8%, 71.1%, 46.7%, 90.8% and 0.85 (95%CI 0.78, 0.92) respectively. CRIB II score had better predictive accuracy for in-hospital mortality among premature neonates compared to ESNS (0.93 v 0.73).
Both CRIB II and ESNS are useful tools to predict the risk of mortality during hospital stay in premature neonates. However, CRIB II score has a better predictive ability for in-hospital mortality in comparison with ESNS.
比较婴儿临床风险指数（CRIB）II评分与新生儿重症扩展评分（ESNS）对孕周≤32周的早产儿院内死亡率的预测价值。
这项前瞻性观察性研究纳入了110例孕周小于或等于32周的早产儿。入院时记录CRIB II评分和ESNS的临床参数，并在24小时内获取实验室参数。比较了两个评分作为死亡率预测指标的敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）和似然比。
CRIB II评分临界值≥10时，其敏感性、特异性、PPV、NPV及受试者工作特征（ROC）曲线下面积分别为85.2%、96.4%、88.5%、95.2%和0.91（95%CI 0.83, 0.98）。ESNS临界值≤11时，相应的值分别为77.8%、71.1%、46.7%、90.8%和0.85（95%CI 0.78, 0.92）。与ESNS相比，CRIB II评分对早产儿院内死亡率的预测准确性更高（0.93对0.73）。
CRIB II评分和ESNS都是预测早产儿住院期间死亡风险的有用工具。然而，与ESNS相比，CRIB II评分对院内死亡率的预测能力更强。
