IMPORTANCE OF CLINICAL RISK INDEX FOR BABIES SCORE FOR PREDICTING NEONATAL MORTALITY IN NICU IN A TERTIARY CARE HOSPITAL

Authors

  • Shahzad Najeeb ATH
  • Ejaz Hussain WMC Atd
  • Muhammad Ali Raza ATH
  • Shabana Sarwar ATH
  • Saima Gillani Associate Professor, Department of Pediatrics, AYUB MEDICAL COLLEGE,ABBOTTABAD.PAKISTAN.
  • Rifayat Ullah Afridi Naseer Teaching Hospital Peshawar
  • Husnain Ali IMDC Islamabad
  • Imran Mahmood Khan Islamabad Medical & Dental College IMDC Isb

Abstract

Background: High mortality among premature and very low birth weight (VLBW) babies necessitates the need to formulate and use scoring systems like CRIB score to predict the mortality in this vulnerable group. Objective of the study was to determine the strength of Clinical Risk Index For Babies (CRIB) score in detecting neonatal mortality in babies presenting with very low birth weight so that timely intervention can be done. It was a cross-sectional study, conducted at NICU, Children Hospital, Pakistan Institute of Medical Sciences Islamabad (PIMS) in nine months starting from First July 2017. Methods: A total of two hundred and fifty-four (n=254) new-borns with birth weight of between 500–1500 grams and gestational age lesser than 35 weeks were included in the study. CRIB score was calculated in all neonates and its association was assessed with mortality during NICU stay. Recorded data was analysed for demographic variables. Means and standard deviation was calculated for numeric variables. Chi-square test was applied to find p-value for the correlation between the main variables. Results: 54.3% (n=138) patients were males and 45.7% (n=116) were females. Mean gestational age was 33.3 weeks±1.04 SD and mean birth weight of study population was 1129.9 grams±210.6 SD. Mean CRIB score among the study population was 6.3±3.1SD and overall mortality was found to be 54.7% (n=139). Mean CRIB score was found to be 8.27±2.1 SD among mortality group and it was 3.87±3.4 SD among new-borns who were discharged (p<0.05). Mortality was present in 4.3% (n=4) of neonates with CRIB score between 1 to 5, 87.1% (n=121) who had CRIB score between 6 to 10 and 100% (n=14) of neonates who had CRIB score level 11–15 (p<0.05), so a significantly higher percentage mortality was noted among neonates with higher CRIB scores. Conclusion: According to our study mean CRIB score is a significant predictor of neonatal mortality.

Author Biographies

Shahzad Najeeb, ATH

Paeds

Ejaz Hussain, WMC Atd

Senior Registrar

Muhammad Ali Raza, ATH

Paeds

Shabana Sarwar, ATH

Paeds

Saima Gillani, Associate Professor, Department of Pediatrics, AYUB MEDICAL COLLEGE,ABBOTTABAD.PAKISTAN.

associate professor,department of paediatrics,ATH, Abbottabad

Rifayat Ullah Afridi, Naseer Teaching Hospital Peshawar

Paeds

Husnain Ali, IMDC Islamabad

S. Reg. IMDC Isb.

Imran Mahmood Khan, Islamabad Medical & Dental College IMDC Isb

AP Paesds

References

Pollack MM, Koch MA, Bartel DA, Rapoport I, Dhanireddy R, El-Mohandes AA, et al. A comparison of neonatal mortality risk prediction models in very low birth weight infants. Pediatrics 2000;105(4):1051–57.

Fowlie PW. CRIB in relation to nosocomial bacteremia in VLBW or preterm. Arch Dis child 1996;75:149–52.

International Neonatal Network. The CRIB (Clinical Risk Index for Babies) Score: a tool for assessing initial neonatal risk and comparing performance of neonatal intensive-care units. Lancet 1993;342(8865):193–8.

Cockburn F, Cooke R, Gamsu H. International Neonatal Network. The CRIB (Clinical risk index for babies) score a tool for assessing initial neonatal risk and comparing performance of neonatal intensive care units. Lancet 1993;342(8865):193–8.

Lund GC, Green D, Browne R, Ackerman NB. New CRIB Score: one score for all NICU admissions † 957. Pediatr Res 1997;41(4):162–6.

Bastos G, Gomes A, Oliveira P. A comparison of 4 pregnancy assessment scales (CRIB, SNAP, SNAP-PE, NTISS) in premature newborns. Clinical Risk Index for Babies. Score for Neonatal Acute Physiology. Score for Neonatal Acute Physiology-Perinatal Extension. Neonatal Therapeutic Intervention Scoring System. Acta Med Port 1997;10(2-3):161–5.

Maier RF, Caspar-Karweck UE, Grauel EL. A comparison of two mortality risk scores for very low birth weight infants: Clinical Risk Index for Babies and Berlin Score. Intens Care Med 2002;28(9):1332–5.

Rautonen J , Makela A, Boyd H. CRIB and SNAP: assessing the risk of death for preterm neonates. Lancet 1994;343(8908):1272–3.

Brito ASJ, Matsuo T, Gonzalez MR, de Caralho AB, Ferrari LS. CRIB score, birth weight and gestational age in neonatal mortality risk evaluation. Rev Saude Publica 2003;37:597–602.

Costeloe KL, Hennessy EM, Haider S, Stacey F, Marlow N, Draper ES. Short term outcomes after extreme preterm birth in England: comparison of two birth cohorts in 1995 and 2006 (the EPICure studies). BMJ 2012;345:e7976.

Matsuoka OT, Sadeck LS, Haber JF, Proenca RS, Mataloun MM, Ramos JL, et al. Predictive value of the "Clinical Risk Index for Babies" for the risk of neonatal death. Rev Saude Publica. 1998;32(6):550–5.

Sarquis AL, Miyaki M, Cat MN. The use of CRIB scores for predicting neonatal mortality risk. J Pediatr (Rio J). 2002;78(3):225–9.

Vakrilova L, Emilova Z, Slŭncheva B, Kalaidzhieva M, Pramatarova T, Larukova N. Using the CRIB as an early prognostic index for very low birthweight infants, treated in neonatal intensive care units. Akush Ginekol (Sofiia) 2007;46(Suppl 1):66–73.

Khanna, R, Taneja V, Singh SK, Kumar N, Sreenivas V, Puliyel JM. The clinical risk index of babies (CRIB) score in India. Indian J Pediatr 2002;69(11):957–60.

Mathew J, Shekarappa BC, Rao NPS. Correlation between Perfusion Index and CRIB Score in Sick Neonates Admitted to a Tertiary Center. J Trop Pediatr 2019;65(1):84–9.

Published

2020-09-07

Most read articles by the same author(s)

1 2 > >>