Illness severity measured by CRIB score: a product of changes in perinatal care?
a Department of
Paediatrics, Derriford Hospital, Plymouth PL6 8DH
Email: harry.baumer{at}phnt.swest.nhs.uk, b Department of Statistics,
Plymouth University, Drake Circus,
Plymouth
Correspondence to: Dr H Baumer.
Accepted 1 May 1997
AIM
To determine the perinatal factors associated
with initial illness severity (measured by the CRIB (clinical risk
index for babies) score) and its relation to survival to discharge.
METHODSA retrospective study was made of
intensive care nursing records on 380 inborn babies, of less than 31 weeks gestation or 1501 g birthweight, admitted to one unit between
1984-6 and 1991-4.
RESULTSBetween the two time periods mean initial
illness severity score increased significantly from 2.8 to 3.9. This
was the result of an increase in the maximum appropriate inspired
oxygen concentration in the first 12 hours. Risk adjusted survival did
not improve over time after accounting for gestation but was
significantly greater after accounting for CRIB score. Illness severity
score was also significantly inversely associated with gestation and 1 and 5 minute Apgar scores, using multiple regression analysis. Between
the two time periods there was also a 92% increase in the admission
rate of babies under 31 weeks gestation, higher median 1 and 5 minute
Apgar scores (6 vs 5 and 9 vs 8, respectively), more multiple births, and more caesarean section deliveries.
CONCLUSIONSThe increase in illness severity score
and admission rate may reflect changes in obstetric practice. The
increase in illness severity score may also reflect changes in early
neonatal care. However, after adjusting for CRIB score, risk adjusted
mortality fell significantly, suggesting that neonatal care 12 hours
from birth onwards had improved with time.
© 1997 by Archives of Disease in Childhood
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
This article has been cited by other articles:
-
Acolet, D., Elbourne, D., McIntosh, N., Weindling, M., Korkodilos, M., Haviland, J., Modder, J., Macintosh, M., on behalf of the Confidential Enquiry Into Materna,
(2005). Project 27/28: Inquiry Into Quality of Neonatal Care and Its Effect on the Survival of Infants Who Were Born at 27 and 28 Weeks in England, Wales, and Northern Ireland. Pediatrics
116: 1457-1465
[Abstract] [Full Text] -
Gagliardi, L, Cavazza, A, Brunelli, A, Battaglioli, M, Merazzi, D, Tandoi, F, Cella, D, Perotti, G F, Pelti, M, Stucchi, I, Frisone, F, Avanzini, A, Bellu, R
(2004). Assessing mortality risk in very low birthweight infants: a comparison of CRIB, CRIB-II, and SNAPPE-II. Arch. Dis. Child. Fetal Neonatal Ed.
89: F419-F422
[Abstract] [Full Text] -
Callaghan, L A, Cartwright, D W, O'Rourke, P, Davies, M W
(2003). Infant to staff ratios and risk of mortality in very low birthweight infants. Arch. Dis. Child. Fetal Neonatal Ed.
88: F94-F97
[Abstract] [Full Text] -
Weinberger, B., Anwar, M., Hegyi, T., Hiatt, M., Koons, A., Paneth, N.
(2000). Antecedents and Neonatal Consequences of Low Apgar Scores in Preterm Newborns: A Population Study. Arch Pediatr Adolesc Med
154: 294-300
[Abstract] [Full Text] -
International Neonatal Network, , Consultants, S. N., Group, N. C. S.
(2000). Risk adjusted and population based studies of the outcome for high risk infants in Scotland and Australia. Arch. Dis. Child. Fetal Neonatal Ed.
82: 118F-123
[Abstract] [Full Text]
- Full Text
- Full Text (PDF)
- Submit a response
- Alert me when this article is cited
- Alert me when eLetters are posted
- Alert me if a correction is posted
- Citation Map
Services
- Email this link to a friend
- Similar articles in ADC Online
- Similar articles in PubMed
- Add article to my folders
- Download to citation manager
- Request Permissions
Citing Articles
Google Scholar
PubMed
Topic Collections
-
Obstetrics and gynaecology
-
Epidemiologic studies
-
Child health
-
Neonatal and paediatric intensive care
-
Neonatal health
Bookmark with
Register for free content
The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.
Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.
