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Comparing different scoring systems for predicting mortality risk in preterm infants: a systematic review and network
Zhaolan Zeng1,2, Zeyao Shi1,2, Xiaowen Li1,2
1Department of Neonatology Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China.
Frontiers in Pediatrics
|January 1, 2024
Summary
The Clinical Risk Index for Babies (CRIB) scoring system is the most accurate for predicting preterm infant mortality risk. This finding can guide clinical practice for better outcomes in high-risk newborns.
Area of Science:
- Neonatal Medicine
- Pediatric Critical Care
- Medical Informatics
Background:
- Preterm infants face significant mortality risks.
- Accurate prediction of mortality risk is crucial for timely intervention.
- Various scoring systems exist to assess risk in preterm infants.
Purpose of the Study:
- To compare the predictive values of eight established scoring systems for preterm infant mortality.
- To identify the most accurate scoring system for clinical application in neonatal intensive care.
Main Methods:
- A systematic literature search was conducted across multiple databases (Embase, PubMed, etc.) up to March 2023.
- Included studies compared different scoring systems for predicting mortality in preterm infants.
- A random-effects network meta-analysis was performed on data from 19 articles involving 14,377 infants.
Main Results:
- The Clinical Risk Index for Babies (CRIB) demonstrated superior predictive efficiency compared to CRIB-II, Neonatal Therapeutical Intervention Score System (NTISS), Neonatal Critical Illness Score (NCIS), Score for Neonatal Acute Physiology II (SNAP-II), and Score for Neonatal Acute Physiology Perinatal Extension II (SNAPPE-II).
- SNAP-II showed worse predictive efficiency than CRIB, Clinical Risk Index for Babies (CRIB-II), and Score for Neonatal Acute Physiology Perinatal Extension (SNAPPE).
- The ranking of scoring systems by predictive accuracy (Area Under the Curve) was: CRIB (0.980) > SNAPPE (0.718) > SNAP (0.534) > CRIB-II (0.525) > NTISS (0.478) > NCIS (0.422) > SNAPPE-II (0.298) > SNAP-II (0.046).
Conclusions:
- The CRIB scoring system exhibits the highest accuracy in predicting mortality risk among preterm infants.
- CRIB is also noted for its simplicity in clinical application.
- Prioritizing the use of the CRIB score in clinical practice is recommended for improved risk assessment and management of preterm infants.
