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Comparison of Clinical Risk Index for Babies (CRIB) II Score and Extended Sick Neonatal Score (ESNS) as a Predictor
Goolla Akhila1, Jasashree Choudhury1, Vijay Kumar Krishnegowda2
1Department of Pediatrics, IMS and SUM Hospital, Bhubaneswar, Odisha, India.
Objective:
To compare Clinical Risk Index for Babies (CRIB) II score and Extended Sick Neonatal Score (ESNS) for predicting in-hospital mortality in premature neonates with gestational age ≤ 32 weeks.
Method:
This prospective observational study included 110 preterm neonates less than equal to 32 weeks of gestation. Clinical parameters of CRIB II score and ESNS were documented at time of admission and laboratory parameter were obtained with 24 h. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and likelihood ratio of the two scores as a predictor of mortality were compared.
Result:
The sensitivity, specificity, PPV, NPV and the Area under the Receiver Operating Characteristic (ROC) curve of CRIB II score at a cut-off value of ≥ 10 were 85.2%, 96.4%, 88.5%, 95.2%, ands 0.91 (95%CI 0.83, 0.98) respectively. The corresponding values for ESNS at a cut-off value of ≤ 11, were 77.8%, 71.1%, 46.7%, 90.8% and 0.85 (95%CI 0.78, 0.92) respectively. CRIB II score had better predictive accuracy for in-hospital mortality among premature neonates compared to ESNS (0.93 v 0.73).
Conclusion:
Both CRIB II and ESNS are useful tools to predict the risk of mortality during hospital stay in premature neonates. However, CRIB II score has a better predictive ability for in-hospital mortality in comparison with ESNS.
