Comprehensive evaluation of total serum bilirubin, amplitude integrated electroencephalogram and brainstem auditory evoked potential and in combination on the early diagnosis of neonatal acute bilirubin encephalopathy by receiver operating characteristic curve

Abstract

Objective To evaluate the levels of total serum bilirubin(TSB), amplitude integrated electroencephalogram(aEEG) monitoring and brainstem auditory evoked potential(BAEP) individually and in combination for the early diagnosis of neonatal acute bilirubin encephalopathy by receiver operating characteristic(ROC) curve. Methods Clinical data was retrospectively analyzed.A total of 152 infants were diagnosed with hyperbilirubinemia, including 119 cases of non-bilirubin encephalopathy group and 33 cases of bilirubin encephalopathy group.The detection results of peak serum bilirubin, aEEG, BAEP combined with the three methods were determined with ROC curve analysis. Results The areas under ROC curve of TSB level, aEEG, BAEP and in combination were 0.900, 0.738, 0.767, 0.925, respectively, the corresponding sensitivity(specificity) in the cut-off point were 90.91%(78.15%), 87.88%(59.66%), 65.52%(87.91%), 93.10%(82.42%), respectively.It showed that the area under ROC curve of the maximum, the comprehensive assessment in diagnostic sensitivity and specificity of the combination of three methods were better than any single detection method by ROC curve. Conclusion The methods of TSB level, aEEG and BAEP play an important role in the diagnosis of neonatal bilirubin encephalopathy, and combination with the three methods can improve the accuracy of diagnosis. Key words: Receiver operating characteristic curve; Bilirubin encephalopathy; Early diagnosis; Neonates,