Predictive values and correlation of CRIB Score II and perfusion index in assessment of severity of illness in sick preterm neonates: An observational study

Article type: Research Article

Authors: Kumar, D.^{a; *} | Kumar, D.^a | Irfan, U.^b | Yadav, Y.S.^c | Yadav, R.K.^a | Kanti, V.^d | Sharma, P.^e | Shukla, S.K.^f

Affiliations: [a] Department of Pediatrics, Uttar Pradesh University of Medical Sciences, Saifai, India | [b] Department of Pediatrics, King George Medical University, Lucknow, India | [c] Department of Pediatrics, All India Institute of Medical Sciences, Bhopal, India | [d] Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Raibarelly, India | [e] Department of Biochemistry, Uttar Pradesh University of Medical Sciences, Saifai, India | [f] Department of Community Medicine, Uttar Pradesh University of Medical Sciences, Saifai, India

Correspondence: [*] Address for correspondence: Dinesh Kumar, MD, Professor, Department of Pediatrics, Uttar Pradesh University of Medical Sciences, Saifai, Etawah, India-206130. Tel.: +91 8475905163; E-mail: [email protected].

Abstract: BACKGROUND:Perfusion index (PI) and CRIB (Clinical risk index of babies) Score II both are minimally invasive tools for prediction of mortality and morbidity in sick neonates. This study aims to know the predictive values of both PI and CRIB Score II in assessment of severity of illness in preterm neonates of 28 to 32 weeks and their correlation. METHODS:PI and CRIB II Score of 125 sick preterm neonates admitted in NICU were assessed within 12 hours of admission. Severity noted in form of outcome. Correlation between PI and CRIB Score II were observed. RESULTS:Receiver operating characteristic (ROC) curve were plotted for PI and CIRB Score II with outcome (discharged vs expired). Area under curve for perfusion index was 0.776 at 95% confidence interval. Optimum cutoff point based on ROC curve was 1.65 with sensitivity of 84%., specificity of 37.2% with positive predictive value of 70% and negative predictive value of 57%. Area under curve for CRIB Score II was 0.622 (p value < 0.028), optimum cut off point based on ROC curve for CRIB II score was 3.5 with sensitivity 79.10% of specificity of 40% positive predictive value is 43.03% and negative predictive value of 76.9%. Spearman’s correlation coefficient between PI and CRIB II score was –0.272 and p value is 0.002. CONCLUSION:This study concluded that perfusion index (p < 0.001) is better for predicting the severity compared to CRIB II score (p < 0.028). A weak negative correlation exists between PI and CRIB II score (r = –0.272).

Keywords: Area under curve, confidence interval, perfusion index, preterm-neonates, receiver operating characteristic

DOI: 10.3233/NPM-240084

Journal: Journal of Neonatal-Perinatal Medicine, vol. 17, no. 5, pp. 723-730, 2024