Kaaresen P I, Døhlen G, Fundingsrud H P, Dahl L B
Department of Paediatrics, University Hospital, Tromsø, Norway.
Acta Paediatr. 1998 Feb;87(2):195-200. doi: 10.1080/08035259850157660.
The CRIB (clinical risk index of babies) score was developed to overcome the disadvantages of birthweight-specific comparisons between neonatal units. The aims of this study were to assess the ability of CRIB score compared to birthweight and gestational age to predict hospital mortality in very low birthweight infants and to use CRIB score in auditing one unit's performance during a prolonged time period. The charts of 335 infants with birthweight < or = 1500 g born between 1980 and 1995 were reviewed retrospectively. CRIB predicted hospital mortality significantly better than birthweight and gestation and performed equally well, whether the infants were treated with synthetic surfactant or not. When adjusting for CRIB score there was a significant improvement in the unit's performance, probably owing to the introduction of surfactant. As small samples tend to be associated with wide confidence intervals, use of CRIB is recommended in comparing risk adjusted mortality in a single unit over several years, as in this study, or between large groups of neonatal units over shorter periods.
CRIB（婴儿临床风险指数）评分的制定是为了克服新生儿病房之间按出生体重进行比较的弊端。本研究的目的是评估CRIB评分与出生体重和胎龄相比，预测极低出生体重儿医院死亡率的能力，并在较长时间段内使用CRIB评分审核一个病房的表现。对1980年至1995年间出生体重≤1500克的335例婴儿的病历进行了回顾性分析。CRIB对医院死亡率的预测明显优于出生体重和胎龄，无论婴儿是否接受合成表面活性剂治疗，其表现均相同。在调整CRIB评分后，该病房的表现有显著改善，这可能归因于表面活性剂的引入。由于小样本往往与较宽的置信区间相关，因此建议如本研究一样，在比较单个病房多年来的风险调整死亡率时，或在较短时间内比较大型新生儿病房组之间的风险调整死亡率时，使用CRIB评分。
