ĐÁNH GIÁ TIÊN LƯỢNG NGUY CƠ TỬ VONG Ở TRẺ SINH NON VỚI THANG ĐIỂM CRIB-II VÀ CÁC YẾU TỐ NGUY CƠ LÂM SÀNG

Abstract

Background: To assess the efficiency of the CRIB II score as a tool to predict the risk for neonatal mortality among the LBW ≤ 1500gr babies admitted to the neonatal intensive care unit (NICU) at the Children Hospital 2, HCM city Vietnam. Methods: Prospective cohort study design where neonates admitted during the first 24 hours to the NICU of the Children Hospital 2, from November 2016 to October 2018 were included. On admission, clinical factors, and variables of CRIB II score were done. Subjects were followed up from admission till discharge or death. Determine the capacity or discriminant khi of quantitative variables between live births and deaths using the area under the ROC curve (AUC). Results: A total of 195 premature infants hospitalized in NICU were included meeting the criteria. The mortality rate was 38.5%. Univariable analysis shows that scleroderma at admission (OR 7.04, 95% CI [1.45 – 34.14], p=0.015), shock within 12 hours of admission (OR 4.36; 95% CI [2.07 – 9.21], p<0.001), CRIB-II ≥ 8.5 (OR 6.73, 95% CI [3.40 – 13.34], p=0.001) were the risk factors of in-hospital death. Multivariate logistic regression shows that scleroderma at admission, shock within 12 hours of admission, and CRIB-II ≥ 8,5 increased the significant risk of in-hospital death independently. The sensitive and specificity predictive mortality of CRIB- II ≥ 8,5 were 72.3% and 72.1%. The area under the curve (AUC) of CRIB- II was 0.753, p< 0.001. Conclusion: Scleroderma at admission, shock within 12 hours of admission, and CRIB-II ≥ 8.5 were the significant risks of in-hospital death in premature infants with birth weight ≤ 1500g. CRIB II score is a valid tool of initial risk assessment in LBW.