Can the early condition at admission of a high-risk infant aid in the prediction of mortality and poor neurodevelopmental outcome? A population study in Australia
Date
2012
Authors
Greenwood, Sarah
Mohamed, Abdel-Latif
Bajuk, Barbara
Lui, Kei
NSW and ACT Neonatal Intensive Care Units Audit Group, unknown
Journal Title
Journal ISSN
Volume Title
Publisher
Blackwell Publishing Ltd
Abstract
Aim: The aim of this article was to evaluate the Revised Clinical Risk Index for Babies' (CRIB-II) severity of illness score as a predictor of moderate to severe functional disability (FD) in very premature infants. Methods: Population study of infants born <29 weeks' gestation cared for in all Neonatal Intensive Care Unit in New South Wales and the Australian Capital Territory between 1998 and 2003. FD at 2-3 years corrected age was defined as developmental delay (quotient < 2 standard deviation), non-ambulatory cerebral palsy (needing aids to walk), blindness (acuity <6/60 in better eye) or deafness (hearing aids). Sensitivity and specificity of CRIB-II scores to predict FD were performed by receiver operating characteristic curve analysis. Results: Of study population of 2210, 480 (21.7%) died before hospital discharge. Among 1328 infants assessed, 217 (16.3%) had FD, 109 (8.2%) developmental delay, 75 (5.6%) cerebral palsy and 54 (4.1%) blindness or deafness. CRIB-II performed significantly better than gestation or birthweight (BW) alone in predicting mortality (area under the curve (AUC) ± standard error 0.83 ± 0.01, vs. 0.78 ± 0.01 and 0.76 ± 0.01, respectively). CRIB-II scores were significantly higher in FD than non-FD children (11.9 ± 2.9 vs. 10.1 ± 2.6), but the AUC for CRIB-II (0.68 ± 0.02) did not significantly differ from that of gestation (0.65 ± 0.02) and BW (0.65 ± 0.02). Conclusion: CRIB-II improved prediction of mortality but did not perform better than gestational age or BW in predicting FD. We would caution clinicians against using the infant's condition at admission to predict long-term outcome.
Description
Keywords
Keywords: article; Australia; birth weight; blindness; cerebral palsy; controlled study; developmental disorder; disability; female; gestational age; hearing impairment; hospital discharge; human; major clinical study; male; newborn; newborn intensive care; newborn CRIB-II; follow-up; neurodevelopmental; outcome; premature infant
Citation
Collections
Source
Journal of Paediatrics and Child Health
Type
Journal article
Book Title
Entity type
Access Statement
License Rights
Restricted until
2037-12-31
Downloads
File
Description