New soft clinical indicators of neonatal illness severity (Accepted as a poster)

Abstract

Background: The Pediatric Risk of Mortality (PRISM) Score serves as a standard for assessing neonatal illness severity. Clinicians also use the Clinical Risk Index for Babies (CRIB) score, American Society of Anesthesiology (ASA) patient classification system, and Patient‐to‐Chart‐Weight Ratio (PCWR).Aims: This study aimed to determine whether parental behaviour itself accurately reflects illness severity.Method: Following Ethics Committee approval, neonates admitted to our Neonatal Intensive Care Unit (NICU) underwent a 12‐week assessment. Investigators determined weekly PRISM and CRIB scores, ASA classifications, and patient and case note weights. Additionally, investigators catalogued possessions in, around, and adhering to patients’ cribs, placing each 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). TOI (Token and Ornament Index), calculated by combining all possessions in the ‘soft toys’, ‘spiritual amulets’, and ‘other items’ categories, correlated nearly so (R2 = 0.71). CRIB Score (R2 = 0.63), ASA classification (R2 = 0.61), and ‘soft toys’ category (R2 = 0.39) all correlated to lesser degrees. Birth and current weight, post conceptual age, NICU days, and PCWR each demonstrated insignificant correlations, the latter even when adjusted for age, NICU days, birth or current weight.Conclusion: Through gift giving, parents reliably reflect PRISM scores and, by extension, neonatal illness severity. Specifically, number of spiritual amulets alone and TOI correlate well and may therefore serve as independent indicators of clinical status and, potentially, anaesthetic risk. Despite widespread application of PCWR, this study found no support for its validity.Keywords: neonatal intensive care; illness severity; PRISM score; parental behaviour.