Journal of Clinical Pediatrics >
Predictive value of different neonatal illness severity scores for predischarge outcomes in very and extremely low birth weight infants
Received date: 2021-04-28
Online published: 2022-08-09
Objective To find sensitive scoring indicators of pre-discharge outcomes in very low birth weight (VLBW) and extremely low birth weight (ELBW) infants. Methods Clinical data of VLBW and ELBW infants admitted from July 1, 2018 to January 31, 2021 were collected. The values of score for neonatal acute physiology version II (SNAP-Ⅱ), simplified version of the score for neonatal acute physiology perinatal extension (SNAPPE-Ⅱ), clinical risk index for babies (CRIB) and neonatal critical illness score (NCIS) were evaluated to predict predischarge death, necrotizing enterocolitis, bronchopulmonary dysplasia, pulmonary hemorrhage, periventricular leukomalacia, and retinopathy in VLBW and ELBW infants. Results A total of 491 VLBW infants were admitted and 223 VLBW infants (including 56 ELBW infants) were selected. In either VLBW or ELBW infants, NCIS score of survival group was higher than that of death group, SNAP-Ⅱ, SNAPPE-Ⅱ and CRIB scores were lower than those of death group, the differences were statistically significant (P<0.05). ROC curve analysis showed that CRIB score had the highest AUC (AUC=0.888, 95%CI: 0.827-0.949) in predicting VLBW death. When CRIB score was 1.5, the Jorden index of predicting VLBW death was 0.672, the sensitivity was 0.944 and the specificity was 0.728. The CRIB score had the highest AUC (AUC=0.901, 95%CI: 0.819-0.982) in predicting the death of ELBW infants. When CRIB score was 5.5, the Jorden index was 0.673, the sensitivity was 0.895 and the specificity was 0.778. Among the four scores, only CRIB had predictive value for bronchopulmonary dysplasia and retinopathy in VLBW infants. All the four scores had predictive value for pulmonary hemorrhage in VLBW infants, but only CRIB had certain predictive value for pulmonary hemorrhage in ELBW infants. Conclusions Among the four kinds of critical score, CRIB has more sensitive predictive value to death risk of VLBW and ELBW infants. However, the predictive value of each score for other predischarge outcomes in VLBW and ELBW infants is still limited, so it is urgent to develop a more appropriate scoring system.
Key words： illness severity score; low birth weight infant; prognosis; neonate
Yang YANG , Xia CHI , Meiling TONG , Xiaoyu ZHOU , Rui CHENG , Jingjing PAN , Xiaoqing CHEN . Predictive value of different neonatal illness severity scores for predischarge outcomes in very and extremely low birth weight infants[J]. Journal of Clinical Pediatrics, 2022 , 40(8) : 608 -615 . DOI: 10.12372/jcp.2022.21e0631
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