Predicting Outcome in Very Low Birthweight Infants Using an Objective Measure of Illness Severity and Cranial Ultrasound Scanning

Overview

Journal Arch Dis Child Fetal Neonatal Ed

Specialties Gynecology & Obstetrics
Pediatrics

Date 1998 Aug 26

PMID 9713027

Citations 7

Authors

P W Fowlie

W O Tarnow-Mordi

C R Gould

D Strang

Affiliations

Soon will be listed here.

Abstract

Aim: To investigate the feasibility of developing an objective tool for predicting death and severe disability using routinely available data, including an objective measure of illness severity, in very low birthweight babies.

Method: A cohort study of 297 premature babies surviving the first three days of life was made. Predictive variables considered included birthweight, gestation, 3 day cranial ultrasound appearances and 3 day CRIB (clinical risk index for babies) score. Models were developed using regression techniques and positive predictive values (PPV) and likelihood ratios (LR) were calculated.

Results: On univariate analysis, birthweight, gestation, 3 day CRIB score and 3 day cranial ultrasound appearances were each associated with death. On multivariate analysis, 3 day CRIB score and 3 day cranial ultrasound appearances remained independently associated. A 3 day CRIB score > 4 along with intraventricular haemorrhage (IVH) grade 3 or 4 was associated with a PPV of 64% and an LR of 9.8 (95% confidence limits 3.5, 27.9). Only 3 day CRIB score and 3 day cranial ultrasound appearances were associated with severe disability on univariate analysis. Both remained independently associated on multivariate analysis. A 3 day CRIB score > 4 along with an IVH grade of 3 or 4 was associated with a PPV of 60% and an LR of 24.2 (95% CI 4.4, 133.3).

Conclusion: Incorporating objective measures of illness severity may improve current prediction of death and disability in premature infants.

Citing Articles

Predicting the outcomes of preterm neonates beyond the neonatal intensive care unit: What are we missing?.

Crilly C, Haneuse S, Litt J Pediatr Res. 2020; 89(3):426-445.

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Neonatal risk mortality scores as predictors for health-related quality of life of infants treated in NICU: a prospective cross-sectional study.

Lah Tomulic K, Mestrovic J, Zuvic M, Rubelj K, Peter B, Bilic Cace I Qual Life Res. 2016; 26(5):1361-1369.

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Prediction of Neurodevelopmental Outcome of Preterm Babies Using Risk Stratification Score.

Sujatha R, Jain N Indian J Pediatr. 2016; 83(7):640-4.

PMID: 26916889 DOI: 10.1007/s12098-016-2050-1.

Cinegraphic versus Combined Static and Cinegraphic Imaging for Initial Cranial Ultrasound Screening in Premature Infants.

ODell M, Cassady C, Logsdon G, Varich L Pediatr Radiol. 2015; 45(11):1706-11.

PMID: 26008871 DOI: 10.1007/s00247-015-3382-0.

Prediction of mortality in very premature infants: a systematic review of prediction models.

Medlock S, Ravelli A, Tamminga P, Mol B, Abu-Hanna A PLoS One. 2011; 6(9):e23441.

PMID: 21931598 PMC: 3169543. DOI: 10.1371/journal.pone.0023441.

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