Illness severity measured by CRIB score: a product of changes in perinatal care?

被引:25
作者
Baumer, JH [1 ]
Wright, D [1 ]
Mill, T [1 ]
机构
[1] UNIV PLYMOUTH, DEPT STAT, PLYMOUTH PL4 8AA, DEVON, ENGLAND
来源
ARCHIVES OF DISEASE IN CHILDHOOD-FETAL AND NEONATAL EDITION | 1997年 / 77卷 / 03期
关键词
CRIB; illness severity score; Apgar scores; admission rates; multiple births; caesarean deliveries;
D O I
10.1136/fn.77.3.F211
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
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. Methods-A 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. Results-Between 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. Conclusions-The 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.
引用
收藏
页码:F211 / F215
页数:5
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