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. 1997 Nov;77(3):F211–F215. doi: 10.1136/fn.77.3.f211

Illness severity measured by CRIB score: a product of changes in perinatal care?

J Baumer, D Wright, T Mill
PMCID: PMC1720719  PMID: 9462192

Abstract

AIM—To determine the perinatal factors associated with initial illness severity (measured by the CRIB (clinical risk index for babies) score) and its relation to survival to discharge.
METHODS—A retrospective study was made of intensive care nursing records on 380 inborn babies, of less than 31 weeks gestation or 1501 g birthweight, admitted to one unit between 1984-6 and 1991-4.
RESULTS—Between the two time periods mean initial illness severity score increased significantly from 2.8 to 3.9. This was the result of an increase in the maximum appropriate inspired oxygen concentration in the first 12 hours. Risk adjusted survival did not improve over time after accounting for gestation but was significantly greater after accounting for CRIB score. Illness severity score was also significantly inversely associated with gestation and 1 and 5 minute Apgar scores, using multiple regression analysis. Between the two time periods there was also a 92% increase in the admission rate of babies under 31 weeks gestation, higher median 1 and 5 minute Apgar scores (6 vs 5 and 9 vs 8, respectively), more multiple births, and more caesarean section deliveries.
CONCLUSIONS—The increase in illness severity score and admission rate may reflect changes in obstetric practice. The increase in illness severity score may also reflect changes in early neonatal care. However, after adjusting for CRIB score, risk adjusted mortality fell significantly, suggesting that neonatal care 12 hours from birth onwards had improved with time.

 Keywords: CRIB; illness severity score; Apgar scores; admission rates; multiple births; caesarean deliveries

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Figure 1  .

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Rate of neonatal admissions by gestation 1984-6 compared with 1991-4.

Figure 2  .

Figure 2  

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Hospital mortality rates using CRIB score, 1984-6 and 1991-4.

Figure 3  .

Figure 3  

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Survival to discharge of babies admitted to neonatal intensive care, 1984-6, compared with those admitted 1991-4.

Figure 4  .

Figure 4  

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Illness severity scores (measured by CRIB), by gestation, 1984-6 and 1991-4.

Figure 5  .

Figure 5  

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ROC curves for CRIB score(—) and birthweight for prediction of hospital mortality.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

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