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Çok Düşük Doğum Ağırlıklı Bebeklerde Crıb-Iı ve Snap-Pe-Iı Skorlama Sistemlerinin Mortalite ve Morbiditeleri Öngörmedeki Etkinliklerinin Karşılaştırılması

Year 2017, Volume: 11 Issue: 3, 183 - 187, 01.08.2017

Abstract

Amaç: Yenidoğan yoğun bakım ünitelerinde (YYBÜ) hastalığın ciddiyetini değerlendirmek ve mortalite ve morbiditeyi öngörmek için oluşturulmuş pek çok skorlama sistemi mevcuttur. Çalışmanın amacı Amerikan ve Avrupa skorlama sistemlerinin son versiyonları olan SNAP-PE-II (Scores for Neonatal Acute Physiology-Perinatal Extension-II) ve CRIB-II (Clinical Risk Index forBabies-II) skorlama sistemlerinin çok düşük doğum ağırlıklı bebeklerde, hastane mortalitesini ve yaşayan infantlarda morbiditeyi tahmin etmedeki etkinliğinin karşılaştırılmasıdır.Gereç ve Yöntemler: Yenidoğan Yoğun Bakım ünitesine yatırılan çok düşük doğum ağırlıklı infantlar çalışmaya dahil edildi. Mortalite ihtimali tahminleri CRIB-II ve SNAP-PE-II skorları kullanılarak hesaplandı. Mortalite ve morbidite tahminlerinin doğruluğunun değerlendirilmesi için reciever operating characteristics (ROC) analizi kullanıldı.Bulgular: Toplam 189 çok düşük doğum ağırlıklı bebek (ortalama CRIB-II: 9.9±3.8; ortalama SNAP-PE-II: 45.8±25.4) çalışmaya dahil edildi. Doğum ağırlığı, gestasyonel yaş, CRIB-II ve SNAPP-II skorları mortalite ile ilişkili saptandı. Hem CRIB-II hem de SNAP-PE-II’nin mortalite için ayrımcılığı iyi saptanırken, ROC analizi ile değerlendirilen morbiditeyi öngörmedeki performansları yetersiz saptandı.Sonuç: Hem CRIB-II hem de SNAP-PE-II skorları hastane mortalitesi tahmininde iyi iken, morbiditeyi tahmin etmede ikisi de yetersizdir. Daha az veri ile hesaplanan CRIB-II skoru daha pratik olduğundan, hasta sayısı fazla olan yenidoğan yoğun bakım ünitelerinde çok düşük doğum ağırlıklı bebeklerin mortalite ihtimalini değerlendirmede öncelikli tercih olabilir.

References

  • Harsha SS, Archana BR. SNAPPE-II (Score for Neonatal Acute Physiology with Perinatal Extension-II) in predicting mortality and morbidity in NICU. J Clin Diagn Res 2015;9:SC10-2.
  • Ezz-Eldin ZM, Hamid TA, Youssef MR, Nabil Hel D. Clinical risk Index for Babies (CRIB II) Scoring System in Prediction of Mortality in Premature Babies. J Clin Diagn Res 2015;9:SC08-11.
  • Richardson DK, Gray JE, McCormick MC, Workman K, Goldmann DA. Score for Neonatal Acute Physiology: A physiologic severity index for neonatal intensive care. Pediatrics 1993;91:617-23.
  • Richardson DK, Phibbs CS, Gray JE, McCormick MC, Workman-Daniels K, Goldmann DA. Birth weight and illness severity: Independent predictors of neonatal mortality. Pediatrics 1993;91:969-75.
  • The CRIB (Clinical Risk Index for Babies) Score: A tool for assessing initial neonatal risk and comparing performance of neonatal intensive care units. The International Neonatal Network. Lancet 1993;342:193-8.
  • 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;105:1051-7.
  • Escobar GJ, Fischer A, Li DK, Kremers R, Armstrong MA. Score for neonatal acute physiology: Validation in three Kaiser Permanente neonatal intensive care units. Pediatrics 1995;96:918-22.
  • Baumer JH, Wright D, Mill T. Illness severity measured by CRIB score: A product of changes in perinatal care? Arch Dis Child Fetal Neonatal Ed 1997;77:F211-5.
  • Petridou E, Richardson DK, Dessypris N, Malamitsi-Puchner A, Mantagos S, Nicolopoulos D, et al. Outcome prediction in Greek neonatal intensive care units using a score for neonatal acute physiology (SNAP). Pediatrics 1998;101:1037-44.
  • Fowlie PW, Gould CR, Tarnow-Mordi WO, Strang D. Measurement properties of the Clinical Risk Index for Babies-reliability, validity beyond the first 12 hours, and responsiveness over 7 days. Crit Care Med 1998;26:163-8.
  • Richardson DK, Corcoran JD, Escobar GJ, Lee SK. SNAP-II and SNAPPE-II: Simplified newborn illness severity and mortality risk scores. J Pediatr 2001;138: 92-100.
  • Parry G, Tucker J, Tarnow-Mordi W. CRIB II: An update of the clinical risk index for babies score. Lancet 2003;361:1789-91.

Comparison of CrIb-II and Snap-Pe-II Scoring Systems in Predicting the Mortality and Morbidity of Very Low Birth Weight Infants

Year 2017, Volume: 11 Issue: 3, 183 - 187, 01.08.2017

Abstract

Objective: A number of illness severity scores have been established to predict mortality and morbidity in neonatal intensive care units (NICUs). The objective of this study was to compare SNAPPE-II (Scores for Neonatal Acute Physiology- Perinatal Extension-II) and CRIB- II (Clinical Risk Index for Babies-II), the latest versions of European and American scoring systems, in predicting hospital mortality and overall morbidity of surviving infants. Material and Methods: Very low birthweight infants (VLBW) admitted to the neonatal intensive care unit were identified. CRIB-II and SNAP-PE-II scores were electronically calculated for each patient via the website www.sfar.org. The receiver operating characteristics (ROC) curve was used to check the accuracy of the mortality and morbidity prediction. results: A total of 189 VLBW neonates (mean CRIB-II:9.9±3.8; mean SNAP-PE-II: 45.8±25.4) were evaluated. The mean birth weight, gestational age, CRIB-II, SNAP-PE-II scores were associated with mortality. Both CRIB-II and SNAPPE-II were determined to be discriminatory for mortality, but not predictive enough for morbidity when evaluated with ROC curve analysis.conclusion: Both CRIB-II and SNAP-PE-II were found to be eligible in predicting hospital mortality of VLBW patients whereas their value was poor in predicting morbidity. CRIB-II, due to fewer parameters to evaluate, may be the preferred scoring system to predict mortality in NICUs with high patient capacity

References

  • Harsha SS, Archana BR. SNAPPE-II (Score for Neonatal Acute Physiology with Perinatal Extension-II) in predicting mortality and morbidity in NICU. J Clin Diagn Res 2015;9:SC10-2.
  • Ezz-Eldin ZM, Hamid TA, Youssef MR, Nabil Hel D. Clinical risk Index for Babies (CRIB II) Scoring System in Prediction of Mortality in Premature Babies. J Clin Diagn Res 2015;9:SC08-11.
  • Richardson DK, Gray JE, McCormick MC, Workman K, Goldmann DA. Score for Neonatal Acute Physiology: A physiologic severity index for neonatal intensive care. Pediatrics 1993;91:617-23.
  • Richardson DK, Phibbs CS, Gray JE, McCormick MC, Workman-Daniels K, Goldmann DA. Birth weight and illness severity: Independent predictors of neonatal mortality. Pediatrics 1993;91:969-75.
  • The CRIB (Clinical Risk Index for Babies) Score: A tool for assessing initial neonatal risk and comparing performance of neonatal intensive care units. The International Neonatal Network. Lancet 1993;342:193-8.
  • 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;105:1051-7.
  • Escobar GJ, Fischer A, Li DK, Kremers R, Armstrong MA. Score for neonatal acute physiology: Validation in three Kaiser Permanente neonatal intensive care units. Pediatrics 1995;96:918-22.
  • Baumer JH, Wright D, Mill T. Illness severity measured by CRIB score: A product of changes in perinatal care? Arch Dis Child Fetal Neonatal Ed 1997;77:F211-5.
  • Petridou E, Richardson DK, Dessypris N, Malamitsi-Puchner A, Mantagos S, Nicolopoulos D, et al. Outcome prediction in Greek neonatal intensive care units using a score for neonatal acute physiology (SNAP). Pediatrics 1998;101:1037-44.
  • Fowlie PW, Gould CR, Tarnow-Mordi WO, Strang D. Measurement properties of the Clinical Risk Index for Babies-reliability, validity beyond the first 12 hours, and responsiveness over 7 days. Crit Care Med 1998;26:163-8.
  • Richardson DK, Corcoran JD, Escobar GJ, Lee SK. SNAP-II and SNAPPE-II: Simplified newborn illness severity and mortality risk scores. J Pediatr 2001;138: 92-100.
  • Parry G, Tucker J, Tarnow-Mordi W. CRIB II: An update of the clinical risk index for babies score. Lancet 2003;361:1789-91.
There are 12 citations in total.

Details

Other ID JA43JM78BK
Journal Section Research Article
Authors

Utku Karaarslan This is me

Özlem Bag This is me

Esra Arun Özer This is me

Mehmet Helvacı This is me

Publication Date August 1, 2017
Submission Date August 1, 2017
Published in Issue Year 2017 Volume: 11 Issue: 3

Cite

Vancouver Karaarslan U, Bag Ö, Özer EA, Helvacı M. Comparison of CrIb-II and Snap-Pe-II Scoring Systems in Predicting the Mortality and Morbidity of Very Low Birth Weight Infants. Türkiye Çocuk Hast Derg. 2017;11(3):183-7.


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