Document Detail

Assessing mortality risk in very low birthweight infants: a comparison of CRIB, CRIB-II, and SNAPPE-II.
MedLine Citation:
PMID:  15321961     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Illness severity scores are increasingly used for risk adjustment in clinical research and quality assessment. Recently, a simplified version of the score for neonatal acute physiology (SNAPPE-II) and a revised clinical risk index for babies (CRIB-II) score have been published. AIM: To compare the discriminatory ability and goodness of fit of CRIB, CRIB-II, and SNAPPE-II in a cohort of neonates < 1500 g birth weight (VLBWI). METHODS: Data from 720 VLBWI, admitted to 12 neonatal units in Lombardy (Northern Italy) participating in a regional network, were analysed. The discriminatory ability of the scores was assessed measuring the area under the receiver operating characteristic curve (AUC). Outcome measure was in-hospital death. RESULTS: CRIB and CRIB-II showed greater discrimination than SNAPPE-II (AUC 0.90 and 0.91 v 0.84, p < 0.0004), partly because of the poor quality of some of the data required for the SNAPPE-II calculation-for example, urine output-but also because of the relative weight given to some items. In addition to each score, several variables significantly influenced survival in logistic regression models. Antenatal steroid prophylaxis, singleton birth, absence of congenital anomalies, and gestational age were independent predictors of survival for all scores, in addition to caesarean section and not being small for gestation (for SNAPPE-II) and a five minute Apgar score of > or = 7 (for SNAPPE-II and CRIB). CONCLUSIONS: CRIB and CRIB-II had greater discriminatory ability than SNAPPE-II. Risk adjustment using all scores is imperfect, and other perinatal factors significantly influence VLBWI survival. CRIB-II seems to be less confounded by these factors.
L Gagliardi; A Cavazza; A Brunelli; M Battaglioli; D Merazzi; F Tandoi; D Cella; G F Perotti; M Pelti; I Stucchi; F Frisone; A Avanzini; R Bellù
Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study    
Journal Detail:
Title:  Archives of disease in childhood. Fetal and neonatal edition     Volume:  89     ISSN:  1359-2998     ISO Abbreviation:  Arch. Dis. Child. Fetal Neonatal Ed.     Publication Date:  2004 Sep 
Date Detail:
Created Date:  2004-08-23     Completed Date:  2004-09-27     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  9501297     Medline TA:  Arch Dis Child Fetal Neonatal Ed     Country:  England    
Other Details:
Languages:  eng     Pagination:  F419-22     Citation Subset:  AIM; IM    
Division of Neonatology and Paediatrics, Ospedale della Versilia, Via Aurelia 335, I-55043 Lido di Camaiore, Lucca, Italy.
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MeSH Terms
Epidemiologic Methods
Hospital Mortality
Infant Mortality*
Infant, Newborn
Infant, Very Low Birth Weight*
Italy / epidemiology
Risk Assessment / methods
Severity of Illness Index*

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