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Can severity‐of‐illness indices for neonatal intensive care predict outcome at 4 years of age?
Author(s) -
Eriksson M,
Bodin L,
Finnström O,
Schollin J
Publication year - 2002
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.2002.tb00105.x
Subject(s) - medicine , pediatrics , neonatal intensive care unit , gestational age , retinopathy of prematurity , intensive care , birth weight , low birth weight , severity of illness , snap , intensive care medicine , pregnancy , genetics , computer graphics (images) , computer science , biology
Aim : To test four neonatal severity‐of‐illness indices (CRIB, NTISS, SNAP, SNAP‐PE) for their ability to predict short‐ and long‐term outcome in very low‐birthweight infants receiving neonatal intensive care. Methods : Data on 240 newborns with birthweights below 1500 g from two Swedish neonatal units were collected. The predictive values of the indices for an adverse outcome in the neonatal period and at 4 y of age were compared with those of gestational age and birthweight. Results : An early adverse outcome (in‐hospital death, severe haemorrhagic‐ischaemic brain lesion, retinopathy, chronic lung disease) was better predicted with CRIB (area under ROC curve (Az) = 0.87) and SNAP‐PE (Az = 0.86), while SNAP‐PE was best for predicting late problems (deviations in growth and psychomotor development, neurosensory impairment, difficulties in concentration, and impairment in vision, and hearing,) (Az = 0.63). All indices predicted the early outcome better than the outcome at the 4‐y follow‐up. Severity‐of‐illness indices can be used as instruments to follow and improve the level of neonatal intensive care, but unfortunately seem to be of little value in long‐term follow‐up. Conclusion : CRIB and SNAP‐PE indices are better in predicting hospital mortality than birth‐weight. None of the systems can predict adverse outcome at 4 y of age.