Clinical Risk Index for Babies (CRIB-II) Scoring System in Prediction of Mortality Risk in Preterm Neonates in the First ۲۴ Hour

  Background: The scoring systems evaluate neonatal outcomes based on perinatal factors in the Neonatal Intense Course Unit (NICU). Aim: This study aimed to predict mortality risk in preterm neonates for the first time, using the Clinical Risk Index for Babies (CRIB II). Method: This cross-sectional, descriptive-analytical, longitudinal study was conducted on ۳۴۴ preterm neonates with the gestational age of ۲۳-۳۲ weeks and birth weight of ۵۰۰-۱۵۰۰ g in a referral center in Tehran, Iran, from winter ۲۰۱۶ to spring ۲۰۱۷. Some neonatal variables were completed within the first ۱۲ h of life, and the final scores were calculated based on CRIB II. Then, the correlation of these variables with mortality outcome was evaluated using logistic regression. Sensitivity, specificity, and positive and negative values were also calculated via SPSS software (version ۲۳). Results: According to the results, ۲۵۳ (۷۳.۵۷%) neonates, including ۱۲۲ girls (۴۸%), survived in the first ۲۴ h after birth. The total CRIB II score in the surviving neonates was ۶.۱±۲.۶. The area under the receiver operating characteristic curve was estimated at ۰.۸۴ with the cut-off point of ۸.۵. In addition, the sensitivity, specificity, positive predictive value, and negative predictive value of the CRIB II system were obtained as ۷۵%, ۷۸%, ۵۵%, and ۸۹.۵%, respectively. The results revealed a significant correlation between the CRIB II score and mortality outcome. In this regard, an increase in the CRIB score coincided with a ۰.۶۷ increase in the risk of death (OR=۱.۶۷۱, p <۰.۰۰۱). Implications for Practice: Based on the findings of the present study,CRIB II can be concluded to be an appropriate scoring system. Consequently, the result of this tool can be used for routine investigations.  

Keywords:

CRIB II , Mortality risk prediction , Preterm newborn