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.
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