Related Experiment Videos
[CRIB score: mortality, morbidity, and long-term neurologic development]
A Coscia1, G Prandi, S Borgione
1Cattedra di Neonatologia, Università di Torino. Coscia@pediatria.unito.it
Insights
The Clinical Risk Index for Babies (CRIB) score effectively predicts mortality and major health issues in very low birth weight (VLBW) infants. Higher CRIB scores correlate with increased risks of mortality, chronic lung disease, retinopathy of prematurity, and neurodevelopmental impairment.
Area of Science:
- Neonatology
- Pediatric critical care
Context:
- Very low birth weight (VLBW) infants face significant risks of mortality and long-term morbidities.
- Accurate risk stratification is crucial for optimizing care and resource allocation in neonatal intensive care units.
Purpose:
- To evaluate the predictive accuracy of the Clinical Risk Index for Babies (CRIB) score for mortality, major pathologies, and neurodevelopmental impairment in VLBW infants.
- To analyze the association between CRIB score categories and specific adverse outcomes including mortality, chronic lung disease (CLD), retinopathy of prematurity (ROP), and neurodevelopmental impairment.
Summary:
- A cohort of 251 VLBW infants was analyzed using the CRIB score, categorized into three risk groups (0-5, 6-10, >10).
- Mortality rates significantly increased with higher CRIB scores (5.6% for 0-5, 32.4% for 6-10, 93.8% for >10).
- Incidence of severe ROP and CLD, as well as neurodevelopmental impairment at one and two years corrected age, also showed a positive correlation with increasing CRIB scores.
Impact:
- The CRIB score demonstrates strong predictive power for mortality in VLBW infants.
- The CRIB score is associated with an increased risk of severe ROP, CLD, and neurodevelopmental impairment, aiding in early identification of high-risk infants.
- Findings support the use of the CRIB score for risk stratification and targeted interventions in VLBW neonates.
Abstract:
The purpose of this study is to assess the possibility of predicting mortality, major pathology and long-term neurodevelopmental impairment in very low birth weight VLBW infant using Clinical Risk Index for Babies (CRIB). We studied a cohort of 251 VLBW infants, whose CRIB could be calculated, born from 1995 to 1998 in our Unit. We analyzed the mortality before discharge, the incidence of chronic lung disease (CLD) and of retinopathy of prematurity (ROP), the length of stay before discharge and the neurodevelopmental impairment at one and two years of corrected age using the Griffiths developmental scales (impairment was defined by a general quotient of 85 or below). The CRIB score was divided into three risk groups: 0-5, 6-10 and > 10. Mortality rate raises with the CRIB's increase (respectively 5.6% in the first group, 32.4% in the second and 93.8% in the third group); besides the incidence of severe ROP and of CLD, calculated in infants survived > 28 days, is higher (18.4% and 40.7% respectively) in the second group than in the first (1.9% and 7.4% respectively). In the end, the incidence of neurodevelopment impairment at one and two years of corrected age is respectively 6.8% and 6.0% for children with CRIB 0-5 and 29.4% and 21.4% for children with CRIB 6-10. CRIB score is strongly associated with mortality and there is an increasing risk for severe ROP, CLD and neurodevelopment impairment from class 0-5 to class 6-10; no statement can be made for these diseases in class > 10 because there is only one survivor in this class.