부산대학교 도서관

Background Practitioners rely on the Pediatric Risk of Mortality (PRISM) Score as the standard for assessing neonatal illness severity. Clinicians also may use the Clinical Risk Index for Babies (CRIB) score, the American Society of Anesthesiology (ASA) patient classification system, length of hospitalization, patient weight, and the anecdotal Patient Chart-to-Patient Weight Ratio (PCPWR). This study aims to determine whether parent-provided possessions at the patient bedside might also accurately reflect neonatal illness severity. Methods The study is prospective observational trial conducted on tertiary surgical Neonatal Intensive Care Unit (NICU) servicing 250 000 km² in Australia with a culturally diverse population. Participants are all neonates admitted to our surgical NICU within a 12-week period. Primary and secondary outcomes measures: Investigators determined weekly PRISM and CRIB scores, ASA classifications, and patient and case note weights. Additionally, investigators catalogued private possessions in, around, and attached to patients' cribs, placing each possession into "soft toys", "spiritual amulets" or "other items" categories. Results Investigators followed 102 neonates, collecting 249 observations. PRISM scores correlated best with the "spiritual amulets" category (R²=0.82). The TOI (Tokens and Ornaments Index), calculated by combining all possessions in the "soft toys", "spiritual amulets", and "other items" categories, correlated next best (R²=0.71). The CRIB Score (R²=0.63), ASA classification (R²=0.61), and "soft toys" category (R²=0.39) all correlated to lesser degrees than TOI. Birth and current weight, post-conceptual age, NICU days and PCPWR each demonstrated insignificant correlations. Conclusions Private bedside possessions reliably reflected PRISM scores and, by extension, neonatal illness severity. Specifically, the number of spiritual items and TOI correlated well and may therefore serve as independent indica of clinical status. This may have potential for also identifying anaesthetic risk. Despite the widespread belief of an association between application of PCPWR and illness severity, this study found no support for its validity. [ABSTRACT FROM AUTHOR]