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Updated: Jun 30, 2026

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
19:15

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale

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CRIB II: an update of the clinical risk index for babies score

Gareth Parry1, Janet Tucker, William Tarnow-Mordi

  • 1Medical Care Research Unit, School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, S1 4DA, Sheffield, UK. g.parry@sheffield.ac.uk <g.parry@sheffield.ac.uk>

Lancet (London, England)
|June 5, 2003
PubMed

Insights

A new Clinical Risk Index for Babies II (CRIB II) score was developed for neonatal intensive care, offering a simpler, recalibrated system. This updated tool addresses concerns about the original CRIB score

Area of Science:

  • Neonatal intensive care
  • Pediatric risk assessment
  • Clinical epidemiology

Background:

  • The Clinical Risk Index for Babies (CRIB) score is a standard tool for risk adjustment in neonatal intensive care.
  • Concerns exist regarding the appropriateness of the original CRIB score with current patient data.
  • Evaluating and updating risk-adjustment tools is crucial for accurate quality assessment in neonatal care.

Purpose of the Study:

  • To examine the appropriateness of the current CRIB score.
  • To develop and validate a new, simplified risk-adjustment score for neonatal intensive care.
  • To assess trends in neonatal mortality over time.

Main Methods:

  • Development of the new five-item CRIB II score using a UK-wide sample of infants admitted to neonatal intensive care in 1998-99.
  • Recalibration and simplification of the scoring system.
  • Analysis of mortality trends in neonatal intensive care over a 12-year period.

Main Results:

  • A new five-item CRIB II score was developed and validated.
  • The CRIB II score offers a recalibrated and simplified system compared to the original CRIB.
  • Mortality rates following neonatal intensive care have decreased over the past 12 years.
  • The new score avoids potential issues related to early treatment bias.

Conclusions:

  • The CRIB II score provides a valid and simplified method for risk adjustment in neonatal intensive care.
  • Accurate risk adjustment is essential for evaluating the quality of neonatal care.
  • Future assessments should integrate both morbidity and mortality measures within national audit systems.

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