Lancet. 1995 Apr 22;345(8956):1020-2.
Risk-adjustment may overcome the disadvantages of birthweight-specific comparisons of neonatal units. Risk-adjusted rates of death or impairment after 18 months were compared in five tertiary and three non-tertiary neonatal units for 695 high-risk infants. CRIB (clinical risk index for babies) was more closely related than birthweight to death or impairment. After adjustment for risk with CRIB, deaths remained more likely after non-tertiary than tertiary care (odds ratio 1.90, 95% CI 1.1-3.3) but rates of impairment in survivors were nearly identical (0.97, 0.5-2.1). To improve performance further, risk-adjusted rates of death and impairment should be monitored for all neonatal units.
风险调整可能会克服新生儿病房按出生体重进行比较的缺点。对5家三级和3家非三级新生儿病房的695名高危婴儿在18个月后的风险调整死亡率或致残率进行了比较。与出生体重相比，CRIB（婴儿临床风险指数）与死亡或致残的关联更为密切。在用CRIB对风险进行调整后，非三级护理后的死亡可能性仍高于三级护理（优势比1.90，95%置信区间1.1 - 3.3），但幸存者的致残率几乎相同（0.97，0.5 - 2.1）。为了进一步提高绩效，应对所有新生儿病房的风险调整死亡率和致残率进行监测。
