Zhang et al reported a score for predicting acute bilirubin encephalopathy (ABE) in a neonate with severe hyperbilirubinemia. The authors are from Zhejiang University in Hangzhou, China.
Patient selection: neonate with severe hyperbilirubinemia (mean total serum bilirubin 29 mg/dL).
Outcome: acute bilirubin encephalopathy (ABE), with a BIND score from 4 to 9
Parameters:
(1) sepsis
(2) total serum bilirubin (TSB) concentration in mg/dL
(3) serum albumin in g/dL
bilirubin to albumin ratio =
= (serum total bilirubin) / (serum albumin)
Parameter |
Finding |
Points |
sepsis |
no |
0 |
|
yes |
12 |
total serum bilirubin |
|
1.5 * (TSB) |
bilirubin to albumin ratio |
|
7 * (ratio) |
total score =
= SUM(points for all of the parameters) - 75
Interpretation:
• The risk of encephalopathy increases with the score.
Total Score |
Percent with ABE |
<= 9 |
0.9% |
10 to 19 |
3.5% |
20 to 29 |
6.8% |
30 to 39 |
14.7% |
40 to 49 |
29.6% |
>= 50 |
76.6% |
Performance:
• The area under the ROC curve is 0.87.
Specialty: Psychiatry, Neurology