Validity of the mean platelet volume and Revised Clinical Risk Index for Babies (CRIB-II) score to assess mortality risk in preterm infants

A. Alshafei, Entesar Zawam, M. Galal, Anwar Hamidullah Khan, Yaser El saba, Moustafa Hassan
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Abstract

This study aimed to investigate the validity of the mean platelet volume (MPV) alone and MPV combined with the revised Clinical Risk Index for Babies (CRIB II) score to predict neonatal mortality in preterm infants. This retrospective observational study performed between May 2018 and June 2021 included preterm neonates (gestational age 23–32 weeks) admitted to a tertiary neonatal intensive care unit (NICU) within 12 hours of birth, who were followed up until death or discharge. MPV was recorded at admission and within 72 hours before death or discharge. The CRIB II score variables were assessed within 12 hours of birth, and the area under the receiver operating characteristic curve (AUC) was calculated for the MPV and CRIB II scores to predict neonatal mortality. We investigated 404 newborns, of whom 28 (6.9%) died. The mean neonatal gestational age was 28.6±2.8 weeks. The MPV was significantly higher in non-survivors than in survivors (p=0.001). The AUC for the MPV and the CRIB II score was 0.68 (95% CI: 0.55–0.80) and 0.85 (95% CI: 0.79–0.91), respectively. The AUC for the MPV combined with the CRIB II score was 0.91 (95% CI 0.87–0.95). The difference in MPV at birth between survivors and non-survivors was statistically non-significant. MPV was found to be a poorer predictor of neonatal mortality than the CRIB II score; however, MPV combined with the CRIB II score demonstrated significantly improved predictive ability for preterm infant mortality risk.
平均血小板体积和修订婴儿临床风险指数(CRIB-II)评分评估早产儿死亡风险的有效性
本研究旨在探讨平均血小板体积(MPV)单独和MPV联合修订后的婴儿临床风险指数(CRIB II)评分预测早产儿新生儿死亡率的有效性。这项回顾性观察性研究于2018年5月至2021年6月期间进行,研究对象为出生后12小时内入住新生儿重症监护病房(NICU)的早产儿(胎龄23-32周),随访至死亡或出院。在入院时和死亡或出院前72小时内记录MPV。在出生12小时内评估CRIB II评分变量,并计算MPV和CRIB II评分的受试者工作特征曲线下面积(AUC),以预测新生儿死亡率。我们调查了404例新生儿,其中28例(6.9%)死亡。新生儿平均胎龄28.6±2.8周。非幸存者的MPV明显高于幸存者(p=0.001)。MPV和CRIB II评分的AUC分别为0.68 (95% CI: 0.55-0.80)和0.85 (95% CI: 0.79-0.91)。MPV合并CRIB II评分的AUC为0.91 (95% CI 0.87-0.95)。幸存者和非幸存者出生时MPV的差异无统计学意义。与CRIB II评分相比,MPV对新生儿死亡率的预测效果较差;然而,MPV结合CRIB II评分显示对早产儿死亡风险的预测能力显著提高。
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