Clinical Risk Index for Babies (CRIB II) Scoring System in Prediction of Mortality in Premature Babies

Ezzeldin, Zahraa; Hamid, Tamer A. Abdel; Youssef, Meray Rene Labib; Nabil, Hossam El-Din

doi:10.7860/jcdr/2015/12248.6012

Cited by 28 publications

(14 citation statements)

References 18 publications

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“…CRIB II score, calculated by assessing 5 combined variables of gender, GA, BW, admission body temperature, and first base excess has been known to a better mortality predictor than GA or BW alone in preterm infants before 32 weeks gestation [ 11 , 20 ]. However, in the present study, the multivariate CRIB II score failed to better predict mortality than its univariate parameters such as GA and BW in ELBWIs during both ≤ 7 th and > 7 th postnatal day in ELBWIs.…”

Section: Discussionmentioning

confidence: 99%

Predicting mortality in extremely low birth weight infants: Comparison between gestational age, birth weight, Apgar score, CRIB II score, initial and lowest serum albumin levels

et al. 2018

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We explored GA, BW, Apgar score, CRIB II score, and serum albumin levels as univariate predictors of mortality in extremely low birth weight infants. Medical records of 564 extremely low birth weight infants were reviewed retrospectively. The infants were grouped as survivors (group I), expired ≤ 7th postnatal day (group II), and expired > 7th postnatal day (group III). The predictive value for mortality of gestational age, birth weight, Apgar scores at 1 and 5 min, clinical risk index for babies II score, and first and lowest serum albumin levels was assessed by calculating the associated area under the curve (AUC) in receiver operating characteristic (ROC) curves. The overall survival and mortality rates of groups I, II, and III were 81.0% (457/564), 7.6% (43/564), and 11.4% (64/564), respectively. Birth weight, Apgar scores at 1 and 5 min, and first serum albumin levels were significantly higher, while the clinical risk index for babies II score was significantly lower in group I when compared to groups II and III. Gestational age and lowest serum albumin level in group I were significantly higher than group III, but not group II. However, gestational age, birth weight, and clinical risk index for babies II score showed gestational age dependent variations regardless of survival or mortality. Apgar score at 5 min (0.756) and lowest serum albumin level (0.771) demonstrated the highest AUC of the ROC curve in predicting mortality in group II and III, respectively. In conclusion, Apgar score at 5 min and lowest serum albumin level were the most effective predictors for mortality in extremely low birth weight infants during ≤ 7th and > 7th postnatal days, respectively.

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Section: Discussionmentioning

confidence: 99%

Predicting mortality in extremely low birth weight infants: Comparison between gestational age, birth weight, Apgar score, CRIB II score, initial and lowest serum albumin levels

et al. 2018

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“…Clinical Risk Index for Babies scoring system II (CRIB-II score) was individually calculated based on GA at birth, BW, body temperature at admission and base excess the first 12 hours. 9 Ninety-eight of the infants were included as a subcohort in a previous bicentre study in Sweden when examining sampling-related blood volumes and blood transfusions. 5…”

Section: Materials and Methods Patients And Clinical Characteristicsmentioning

confidence: 99%

“…CRIB-II score was coded as high (CRIB-II ≥11, corresponding to CRIB level 3-4) or low (CRIB-II level <11, corresponding to CRIB level 1-2). 9 Independent confounding variables included in the full model were GA at birth, BW SGA, sex, highest and lowest fractional inspired oxygen (FiO 2 ) during the first 12 hours of life and CRIB-II score (dichotomous). The independent respective contributions of HbF, PaO 2 and total Hb to BPD during postnatal week 1 were assessed using multiple variable analysis.…”

Section: Statisticsmentioning

confidence: 99%

Fetal haemoglobin and bronchopulmonary dysplasia in neonates: an observational study

Hellström

Martinsson

Hellström

et al. 2020

Arch Dis Child Fetal Neonatal Ed

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ObjectiveEarly decrease in fetal haemoglobin (HbF) is an indicator of loss of endogenous blood components that might have predictive value for development of bronchopulmonary dysplasia (BPD). The link between HbF and BPD has not been evaluated.DesignRetrospective observational study.SettingTertiary level neonatal intensive care unit, referral centre for Southern Sweden.Patients452 very preterm infants (<30 gestational weeks) born 2009–2015.InterventionsRegular clinical practice.Main outcome measuresMean HbF, haemoglobin (Hb) and partial oxygen pressure (PaO2) levels calculated from 11 861 arterial blood gas analyses postnatal week 1. Relationship between HbF (%) and BPD (requirement of supplemental oxygen at 36 weeks’ postmenstrual age) and the modifying influence of PaO2 (kPa) and total Hb (g/L) was evaluated.ResultsThe mean gestational age (GA) at birth was 26.4 weeks, and 213 (56%) infants developed BPD. A 10% increase in HbF was associated with a decreased prevalence of BPD, OR 0.64 (95% CI 0.49 to 0.83; p<0.001). This association remained when adjusting for mean PaO2 and Hb. Infants with an HbF in the lowest quartile had an OR of 27.1 (95% CI 11.6 to 63.4; p<0.001) for development of BPD as compared with those in the highest quartile. The area under the curve for HbF levels and development of BPD in the full statistical model was 0.871.ConclusionsEarly rapid postnatal decline in HbF levels was associated with development of BPD in very preterm infants. The association between HbF and BPD was not mediated by increased oxygen exposure. The potential benefit of minimising loss of endogenous blood components on BPD outcome will be investigated in a multicentre randomised trial.

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“…For each infant, the following data were recorded: history of maternal hypertension (MH) prior to delivery as defined by American College of Obstetricians and Gynecologists (21), antenatal evidence of abnormal umbilical flow at Doppler evaluation, maternal chorioamnionitis, GA, birth weight, Apgar score at 1' and 5' (22), clinical risk index for babies II (CRIB II) score (23), gender, twin birth, echocardiographic evidence of an hemodynamically significant patent ductus arteriosus (PDA) over the first week of life, development of medical and/or surgical necrotizing enterocolitis (24) and/or sepsis (defined by clinical signs and symptoms and positive blood culture or C-reactive protein ≥2.5 mg/dl) and need for antibiotics for ≥5 days) (25) during the study period.…”

Section: Methodsmentioning

confidence: 99%

Biomarkers of Kidney Injury in Very-low-birth-weight Preterm Infants: Influence of Maternal and Neonatal Factors

Capelli

Vitali

Zappulo

et al. 2020

In Vivo

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Background/Aim: Acute kidney injury is an important cause of mortality in very-low-birth-weight (VLBW) preterm infants. As in the general population, the detection of renal damage cannot rely on the measurement of serum creatinine, since it has been demonstrated to be a weak predictor and a delayed indicator of kidney function deterioration. However, several candidate biomarkers have failed to prove sufficient specificity and sensitivity for a routine clinical use because of the poor awareness of their biological role. This study was aimed to investigate the impact of different maternal and neonatal conditions on several renal biomarkers in VLBW preterm infants during the first week of life. Patients and Methods: Preterm infants<32 weeks' gestation and <1500g were enrolled. We measured urinary biomarkers kidney injury molecule 1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL), cystatin C, epidermal growth factor (EGF) and osteopontin (OPN) on the 1 st , 3 rd , and 7 th day after birth. Results: Thirty-tree infants were included. The multivariate analysis showed a significant association between gestational age, the presence of patent ductus arteriosus, antenatal maternal hypertension and the levels of urinary biomarkers. Conclusion: There is a possible relation between early biomarkers of renal injury and antenatal, perinatal and post-natal characteristics in VLBW preterm infants during the first week of life. Preterm birth is burdened by high rates of perinatal morbidity and mortality worldwide (1). With an estimated incidence of 12-18%, acute kidney injury (AKI) is among the main causes of mortality in the preterm population, and represents an independent predictor of mortality even after adjustment for confounding variables, namely comorbidities, interventions and demographic characteristics (2, 3). Preterm birth is also associated with an increased risk of cardiovascular and chronic kidney disease in adulthood; this poses important challenges for the clinicians to detect as soon as possible developmental and functional abnormalities that could affect lifetime (4, 5). In humans and experimental animals, however, measurable changes in serum creatinine and glomerular filtration rates can be evident only after a remarkable reduction in kidney function (less than 50-80% of normal values), being thus insensitive to detect subclinical renal damage. Moreover, serum creatinine levels can be influenced by several factors, such as gender, age, hydration state, muscle mass, ongoing medications and endogenous metabolites (e.g., bilirubin) (3, 6). In the neonatal population, AKI definitions based on serum creatinine are susceptible to specific additional limitations: in the first days of life, serum creatinine may reflect the maternal kidney function (7, 8) and it is not able to distinguish pre-renal injuries, which are often reversible and transient, from intrinsic renal injuries (9). Moreover, serum creatinine does not provide specific information on the type of kidney insult (e.g., toxic, infectious, ischemic...

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Clinical Risk Index for Babies (CRIB II) Scoring System in Prediction of Mortality in Premature Babies

Cited by 28 publications

References 18 publications

Predicting mortality in extremely low birth weight infants: Comparison between gestational age, birth weight, Apgar score, CRIB II score, initial and lowest serum albumin levels

Predicting mortality in extremely low birth weight infants: Comparison between gestational age, birth weight, Apgar score, CRIB II score, initial and lowest serum albumin levels

Fetal haemoglobin and bronchopulmonary dysplasia in neonates: an observational study

Biomarkers of Kidney Injury in Very-low-birth-weight Preterm Infants: Influence of Maternal and Neonatal Factors

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