The Accuracy of Clinical Risk Index for Babies (CRIB-II) for Predicting Mortality of Severely-ill Preterm Neonates

Abstract

Background: In Pakistan neonatal mortality rate is 47.3 among 1000 live births. Predictors of neonatal mortality risk can be used to prioritize the care for neonates and to improve the outcome. Objective: To determine the accuracy of clinical risk index for babies (CRIB-II) for predicting mortality of severely ill preterm neonates. Study Design: A Cross Sectional Study. Settings: NICU, Department of Pediatrics Unit I and Unit II, Mayo Hospital, Lahore Pakistan. Duration: From January 22, 2016 to July 30, 2016. Methodology: 200 cases fulfilling the selection criteria (Gestational age 26­34 weeks, Preterm admitted in NICU within 12 hours of birth), were included in the study by nonprobability, Consecutive Sampling. Babies with lethal malformations were excluded. Data required for CRIB II score was collected and analyzed by SPSS. Results: Out of the 200 cases, 102 patients were male (51 %). Age varies from 1 hour to 9 hours of life with mean of 5.8. Gestational age ranges from 28 weeks to 33 weeks with mean age is 30 weeks. Patients had following diagnosis with number of cases: Respiratory distress syndrome 54; Early onset sepsis 30; PT, JNN, EOS 22; Mild Asphyxia 18; Prematurity 14; RDS, EOS 14; Moderate Asphyxia 10; prematurity, Jaundice neonatorum 8; IUGR 8; Early onset sepsis, DIC 4; PT, NEC, EOS 4.  CRIB score has sensitivity of 77.7 %, specificity of 65.4 %. It has positive predictive value of 64.8 %, negative predictive value of 78.2 % & clinical accuracy of 71%. Conclusion: CRIB II score has clinical accuracy of 71 % determining prognosis of severely ill preterm neonates in term of mortality.