Prognostic Value of CRIB, CRIB II and SNAP II Scores in Critically Ill Preterm Neonates

Abstract

Assessing neonatal illness severity is an important issue in the Neonatal Intensive Care Unit (NICU) So, the standardized comparisons of outcomes are important to be performed across health care facilities Illness severity scores were thus developed during 1993 four scoring systems for assessing neonatal mortality risk were introduced as follow: the national institutes of health neonatal network model, SNAP, SNAP-PE and CRIB. Then SNAP II and CRIB II were developed later in NICUs and introduced as robust indices of neonatal risk, to predict mortality and morbidity in newborns. The aim of the current study was: 1. To assess the predictive value of CRIB, CRIB II, SNAPII scores & serum lactate level for premature neonates hospital mortality. 2. To compare the predictive value of CRIB, CRIB II, SNAP II scores & serum lactate level for premature neonates hospital mortality. 3. To determine if repeated serum lactate level after the first day is useful in identifying neonatal intensive care unit (NICU) patients who die or develop severe adverse outcomes. 4. To study if addition of perinatal extension (BW, if small for GA, Apgar score at 5 minute) to SNAP II score can improve its predictive value to mortality or sever adverse outcomes. Our study was a prospective one which included 100 critically ill Preterm newborn admitted to neonatal intensive care unit in Ain Shams University Hospital in a period from June 2013 to february 2014. Inclusion criteria : • A preterm baby with gestaional age less than 32 weeks • Critically ill : haemodynamically unstable Exclusion criteria: • Death or discharge from the neonatal intensive care unit in the first 24 hours of life. • Lethal congenital malformations. • Newborns who had been referred to other hospitals during the course of management. • Incomplete data preventing the calculation of a CRIB score.