Abstract
A prospective study of the outcome of care of a regional cohort of very low birthweight (< 1500 g) and very preterm (< 32 weeks) infants was carried out. Its aims were to assess the ability of the CRIB (clinical risk index for babies) score, rather than gestational age or birthweight, to predict mortality before hospital discharge, neurological morbidity, and length of stay, and to access CRIB score as an indicator of neonatal intensive care performance. 676 live births fulfilled the criteria and complete data were available for 643 (95%). Compared with gestation and birthweight, CRIB was better for the prediction of mortality, was as good for the prediction of morbidity, and was not as good for the prediction of length of stay. CRIB adjusted mortality did not demonstrate better performance in units providing the highest level of care. Either the CRIB score was not sensitive to performance or the level 3 hospitals in this study were performing badly. On the basis of this analysis purchasers and providers of neonatal intensive care cannot yet rely on the CRIB score as a performance indicator.
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- Altman D. G., Bland J. M. Diagnostic tests 3: receiver operating characteristic plots. BMJ. 1994 Jul 16;309(6948):188–188. doi: 10.1136/bmj.309.6948.188. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Costello A. M., Hamilton P. A., Baudin J., Townsend J., Bradford B. C., Stewart A. L., Reynolds E. O. Prediction of neurodevelopmental impairment at four years from brain ultrasound appearance of very preterm infants. Dev Med Child Neurol. 1988 Dec;30(6):711–722. doi: 10.1111/j.1469-8749.1988.tb14633.x. [DOI] [PubMed] [Google Scholar]
- Fenton A. C., Field D. J., Solimano A., Annich G. The CRIB score. Lancet. 1993 Sep 4;342(8871):612–613. [PubMed] [Google Scholar]
- Field D., Hodges S., Mason E., Burton P. Survival and place of treatment after premature delivery. Arch Dis Child. 1991 Apr;66(4 Spec No):408–411. doi: 10.1136/adc.66.4_spec_no.408. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Grant J. M. The CRIB score. Lancet. 1993 Sep 4;342(8871):612–613. [PubMed] [Google Scholar]
- Horbar J. D., Onstad L., Wright E. Predicting mortality risk for infants weighing 501 to 1500 grams at birth: a National Institutes of Health Neonatal Research Network report. Crit Care Med. 1993 Jan;21(1):12–18. doi: 10.1097/00003246-199301000-00008. [DOI] [PubMed] [Google Scholar]
- Johnson A., Townshend P., Yudkin P., Bull D., Wilkinson A. R. Functional abilities at age 4 years of children born before 29 weeks of gestation. BMJ. 1993 Jun 26;306(6894):1715–1718. doi: 10.1136/bmj.306.6894.1715. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Paneth N., Kiely J. L., Wallenstein S., Marcus M., Pakter J., Susser M. Newborn intensive care and neonatal mortality in low-birth-weight infants: a population study. N Engl J Med. 1982 Jul 15;307(3):149–155. doi: 10.1056/NEJM198207153070303. [DOI] [PubMed] [Google Scholar]
- Papile L. A., Burstein J., Burstein R., Koffler H. Incidence and evolution of subependymal and intraventricular hemorrhage: a study of infants with birth weights less than 1,500 gm. J Pediatr. 1978 Apr;92(4):529–534. doi: 10.1016/s0022-3476(78)80282-0. [DOI] [PubMed] [Google Scholar]
- Powell P. J., Powell C. V., Hollis S., Robinson M. J. When will my baby go home? Arch Dis Child. 1992 Oct;67(10 Spec No):1214–1216. doi: 10.1136/adc.67.10_spec_no.1214. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Report of working group of the British Association of Perinatal Medicine and Neonatal Nurses Association on categories of babies requiring neonatal care. Arch Dis Child. 1992 Jul;67(7 Spec No):868–869. doi: 10.1136/adc.67.7_spec_no.868. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Richardson D. K., Gray J. E., McCormick M. C., Workman K., Goldmann D. A. Score for Neonatal Acute Physiology: a physiologic severity index for neonatal intensive care. Pediatrics. 1993 Mar;91(3):617–623. [PubMed] [Google Scholar]
- Richardson D. K., Phibbs C. S., Gray J. E., McCormick M. C., Workman-Daniels K., Goldmann D. A. Birth weight and illness severity: independent predictors of neonatal mortality. Pediatrics. 1993 May;91(5):969–975. [PubMed] [Google Scholar]
- Roberton N. R. Should we look after babies less than 800 g? Arch Dis Child. 1993 Mar;68(3 Spec No):326–329. doi: 10.1136/adc.68.3_spec_no.326. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Sepkowitz S. The CRIB score. Lancet. 1993 Oct 9;342(8876):938–938. [PubMed] [Google Scholar]
- Verloove-Vanhorick S. P., Verwey R. A., Brand R., Gravenhorst J. B., Keirse M. J., Ruys J. H. Neonatal mortality risk in relation to gestational age and birthweight. Results of a national survey of preterm and very-low-birthweight infants in the Netherlands. Lancet. 1986 Jan 11;1(8472):55–57. doi: 10.1016/s0140-6736(86)90713-0. [DOI] [PubMed] [Google Scholar]