Comparison of the Predictive Accuracy of Stool Color for Triage of Infants for Phototherapy (STrIP) Score With Transcutaneous Bilirubinometer in Predicting Serum Bilirubin in Neonates

Abstract

To compare the agreement of stool color for triage of infants for phototherapy (STrIP) score and transcutaneous bilirubinometer values with measured serum bilirubin in neonatal hyperbilirubinemia. Babies more than 35 weeks of gestation, with clinical jaundice, and on exclusive breastfeeding were included in the study. Babies with who were clinically unstable or who had received phototherapy based on clinical assessment were excluded. The agreement was analyzed using Bland-Altman charts. Results of three non-invasive methods were further compared with the measured serum bilirubin levels. There was a mean difference of 4 mg/dL of bilirubin between transcutaneous bilirubin and serum bilirubin levels, whereas the agreement between the STrIP score and Serum bilirubin shows a difference of only 2 mg/dL. On further analysis of Kramer, transcutaneous and STrIP score, method of bilirubin estimation against serum bilirubin, there was a mean difference 6 mg/dL, 4 mg/dL and 2 mg/dL, respectively. STrIP score has the best agreement with serum bilirubin in neonates compared to other non-invasive techniques such as transcutaneous bilirubinometry and clinical assessment using Kramer scale.