Research Article
CRIB II, SNAPPE-II ve NTISS Skorlama Sistemleri ile Yenidoğan Yoğun Bakım Ünitesinde Mortalite Riski Belirlenmesi
Abstract
Giriş: Yenidoğan yoğun bakım ünitelerinde (YYBÜ) özellikle düşük doğum ağırlıklı bebeklerin klinik durumunu belirleme, mortalite riskini öngörme ve uygun yaklaşımı planlamanın yanı sıra üniteler arasında mortalite oranlarının objektif olarak değerlendirilmesini sağlamak amacıyla skorlama sistemleri geliştirilmiştir.
Amaç: Çalışmamızda yaşamın ilk gününde YYBÜ’ne yatırılan çok düşük doğum ağırlıklı (ÇDDA) bebeklerde, Clinical Risk Index for Babies II (CRIB-II), Score for Neonatal Acute Physiology-Perinatal Extension II (SNAPPE II) ve Neonatal Therapeutic Intervention Scoring System (NTISS) isimli farklı üç skorlama sisteminin mortalite riskini belirleyiciliğini araştırmayı ve bu puanlar için optimal kestirim değerleri saptamayı amaçladık.
Yöntem ve Gereçler: Ocak 2009-Haziran 2012 tarihleri arasında T.C. Sağlık Bakanlığı, Kamu Hastaneleri Kurumu, İstanbul İli (Fatih) Kamu Hastaneler Birliği Süleymaniye Doğum ve Kadın Hastalıkları Eğitim ve Araştırma Hastanesi Çocuk Kliniği YYBÜ‘nde izlenen doğum ağırlığı ≤1500 gr, doğum haftası ≤32 hafta olan ÇDDA 169 hastanın dosyası retrospektif olarak değerlendirildi.
Bulgular: Her üç skorlama için mortalite açısından optimal kestirim değerleri CRIB-II için 10 (%71.4 duyarlılık-%84.3 özgüllük, AUC 0.778, p<0,001), SNAPPE-II için 34 (%81 duyarlılık-%78 özgüllük, AUC 0.795, p<0,001), NTISS için 18 (%83.3 duyarlılık-%57,5 özgüllük, AUC 0.704, p<0,001) saptandı. Çok değişkenli lojistik regresyon analizinde CRIB-II ve SNAP-PE II için belirtilen kestirim noktaları üzerinde mortalite riskinin sırasıyla 3.43 ve 5.33 kat arttığı saptandı (p:0.022, p:0.003).
Sonuç: Çalışmamızda yenidoğan döneminde her üç skorlamanın da mortalite riskini öngörmek amacı ile kullanılabileceği, ancak SNAPPE-II skorlama sisteminin CRIB II skorlama sistemine göre, her ikisinin de NTISS skorlama sistemine göre daha avantajlı olduğu sonucuna varıldı
Ethical Statement
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References
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- 10- Bell MJ, Ternberg JL, Feigin RD, Keating JP, Marshall R, Barton L et al. Neonatal necrotizing enterocolitis. Therapeutic decisions based upon clinical staging. Ann Surg 1978;187:1-7.
- 11- Pollack MM, Ruttimann UE, Getson PR. Pediatric Risk of Mortality score. (PRISM) Crit Care Med 1988; 16:1110-1116.
- 12- Fleisher BE, Murthy L, Lee S, Constantinou JC, Benitz WE, Stevenson DK. Neonatal severity of illness scoring systems: a comparison. Clin Pediatr 1997; 36:223-227.
- 13- Dorling JS, Field DJ, Manktelow B. Neonatal disease severity scoring systems. Arch Dis Child Fetal Neonatal Ed 2005; 90:F11-F16.
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- 19- Reid S, Bajuk B, Lui K, Sullivan EA; NSW and ACT Neonatal Intensive Care Units Audit Group, PSN. Comparing CRIB-II and SNAPPE-II as mortality predictors for very preterm infants. J Paediatr Child Health. 2015;51(5):524-528.
- 20- Wu PL, Lee WT, Lee PL, Chen HL. Predictive power of serial neonatal therapeutic intervention scoring system scores for short-term mortality in very-low-birth-weight infants. Pediatr Neonatol. 2015;56(2):108-13.
- 21- Dammann O, Shah B, Naples M, Bednarek F, Zupancic J, Allred EN, et al, ELGAN Study Investigators. Interinstitutional variation in prediction of death by SNAP-II and SNAPPE-II among extremely preterm infants. Pediatrics. 2009;124(5):e1001-6.
- 22- Özcan B, Kavurt AS, Aydemir Ö, Gençtürk Z, Baş AY, Demirel N. SNAPPE-II and risk of neonatal morbidities in very low birth weight preterm infants. Turk J Pediatr. 2017;59(2):105-112.
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Year 2023,
Volume: 13 Issue: 4, 557 - 566, 30.12.2023
Abstract
References
- KAYNAKLAR 1- Ahmed B, Abushama M, Konje JC. Prevention of spontaneous preterm delivery - an update on where we are today. J Matern Fetal Neonatal Med. 2023;36(1):2183756.
- 2- Blencowe H, Cousens S, Chou D, Oestergaard M, Say L, Moller AB et al. Born Too Soon Preterm Birth Action Group. The global epidemiology of 15 million preterm births.. Reprod Health. 2013;10(S1):S2.
- 3- Sotodate G, Oyama K, Matsumoto A, Konishi Y, Toya Y, Takashimizu N. Predictive ability of neonatal illness severity scores for early death in extremely premature infants. J Matern Fetal Neonatal Med. 2022;35(5):846-851.
- 4- Kinney MV, Rhoda NR. Understanding the causes of preterm birth: solutions depend on context. Lancet Glob Health. 2019;7(8):e1000-e1001.
- 5- Ballard JL, Novak KK, Driver M. A simplified score for assessment of fetal maturation of newly born infants. Pediatrics. 1979;95:769-74.
- 6- Lubchenco LO: A Practial Classification for Newborn Infant by Weight and Gestational, Age. J Pediatr 1967; 71:159.
- 7- Rudolph AJ, Smith CA. Idiopathic RDS of the newborn. J Pediatrics 1960;57:905-21.
- 8- Shennan AT, Dunn MS, Ohlsson A, Lennox K, Hoskins EM. Abnormal pulmonary outcomes in premature infants: prediction from oxygen requirement in the neonatal period. Pediatrics 1988;82(4):527-32.
- 9- Papile LA, Munsick-Bruno G, Schaefer A. Relationship of cerebral intraventricular hemorrhage and early childhood neurologic handicaps. J Pediatr 1983;103(2):273-7.
- 10- Bell MJ, Ternberg JL, Feigin RD, Keating JP, Marshall R, Barton L et al. Neonatal necrotizing enterocolitis. Therapeutic decisions based upon clinical staging. Ann Surg 1978;187:1-7.
- 11- Pollack MM, Ruttimann UE, Getson PR. Pediatric Risk of Mortality score. (PRISM) Crit Care Med 1988; 16:1110-1116.
- 12- Fleisher BE, Murthy L, Lee S, Constantinou JC, Benitz WE, Stevenson DK. Neonatal severity of illness scoring systems: a comparison. Clin Pediatr 1997; 36:223-227.
- 13- Dorling JS, Field DJ, Manktelow B. Neonatal disease severity scoring systems. Arch Dis Child Fetal Neonatal Ed 2005; 90:F11-F16.
- 14- Gray JE, Richardson DK, Mccormick MC, Workman-Daniels K, Goldmann DA. Neonatal Therapeutic Interventions Scoring System: a therapy-based severity-of-illness index. Pediatrics 1992; 90:561-567.
- 15- Gagliardi L, Cavazza A, Brunelli A, Battaglioli M, Merazzi D, Tandoi F. et al. Assessing mortality risk in very low birthweight infants: A comparison of CRIB, CRIB-II, and SNAPPE-II. Arch. Dis. Child. Fetal Neonatal Ed. 2004; 89:F419–22
- 16- McLeod JS, Menon A, Matusko N, Weiner GM, Gadepalli SK, Barks J, Comparing mortality risk models in VLBW and preterm infants: systematic review and meta-analysis. J Perinatol. 2020;40(5):695-703.
- 17- Yalaz M, Arslan T, Çoşar H, Akısu M, Kültürsay N. Neonatal mortalite riskinin belirlenmesinde farklı skorlama sistemlerinin karşılaştırılması: çok düşük doğum ağırlıklı bebeklerde CRIB ve SNAP-PE-II Çocuk Sağlığı ve Hastalıkları Dergisi 2006; 49:1-7.
- 18- Asker HS, Satar M, Yıldızdaş HY, Mutlu B, Özyurt BM, İpek MŞ,. Evaluation of Score for Neonatal Acute Physiology and Perinatal Extension II and Clinical Risk Index for Babies with additional parameters. Pediatr Int. 2016;58(10):984-987.
- 19- Reid S, Bajuk B, Lui K, Sullivan EA; NSW and ACT Neonatal Intensive Care Units Audit Group, PSN. Comparing CRIB-II and SNAPPE-II as mortality predictors for very preterm infants. J Paediatr Child Health. 2015;51(5):524-528.
- 20- Wu PL, Lee WT, Lee PL, Chen HL. Predictive power of serial neonatal therapeutic intervention scoring system scores for short-term mortality in very-low-birth-weight infants. Pediatr Neonatol. 2015;56(2):108-13.
- 21- Dammann O, Shah B, Naples M, Bednarek F, Zupancic J, Allred EN, et al, ELGAN Study Investigators. Interinstitutional variation in prediction of death by SNAP-II and SNAPPE-II among extremely preterm infants. Pediatrics. 2009;124(5):e1001-6.
- 22- Özcan B, Kavurt AS, Aydemir Ö, Gençtürk Z, Baş AY, Demirel N. SNAPPE-II and risk of neonatal morbidities in very low birth weight preterm infants. Turk J Pediatr. 2017;59(2):105-112.
- 23- Vardhelli V, Murki S, Tandur B, Saha B, Oleti TP, Deshabhotla S, Comparison of CRIB-II with SNAPPE-II for predicting survival and morbidities before hospital discharge in neonates with gestation ≤32 weeks: a prospective multicentric observational study. Eur J Pediatr. 2022;181(7):2831-2838.
There are 23 citations in total.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Health Services and Systems (Other) |
| Journal Section | Articles |
| Authors | |
| Publication Date | December 30, 2023 |
| Submission Date | October 16, 2023 |
| Acceptance Date | December 26, 2023 |
| Published in Issue | Year 2023 Volume: 13 Issue: 4 |
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