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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Neonatal disease severity scoring systems
J S Dorling1, D J Field, B Manktelow
1Department of Health Sciences, University of Leicester, Neonatal Unit, Leicester Royal Infirmary, Leicester LE1 5WW, UK. JSD10@le.ac.uk
Insights
Illness severity scores are common in neonatal intensive care for comparing infant mortality rates. However, their use in providing prognostic information to parents about their baby remains limited.
Area of Science:
- Neonatal intensive care
- Medical informatics
- Pediatric research
Background:
- Illness severity scores are frequently utilized in neonatal intensive care units (NICUs).
- These scores primarily adjust observed mortality rates for infant morbidity, enabling standardized comparisons.
- Risk correction is common in audits and research involving infant groups.
Purpose of the Study:
- To review the strengths and weaknesses of current disease severity correction methods in newborns.
- To explore the limited application of these scores in providing prognostic information to parents.
Main Methods:
- Review of existing literature on illness severity scores in neonatal intensive care.
- Analysis of the application and limitations of these scores for risk adjustment and parental communication.
Main Results:
- Illness severity scores are well-established for comparative audits and research in NICUs.
- Significant limitations exist in using these scores for individual infant prognostication to parents.
Conclusions:
- While valuable for group comparisons, current illness severity scores have limited utility for direct parental prognostic counseling.
- Further development or adaptation of scoring systems may be needed to improve their application in individual patient communication.
Abstract:
Illness severity scores have become widely used in neonatal intensive care. Primarily this has been to adjust the mortality observed in a particular hospital or population for the morbidity of their infants, and hence allow standardised comparisons to be performed. However, although risk correction has become relatively commonplace in relation to audit and research involving groups of infants, the use of such scores in giving prognostic information to parents, about their baby, has been much more limited. The strengths and weaknesses of the existing methods of disease severity correction in the newborn are presented in this review.
