STrIP Score for Neonatal Jaundice: From Bench to Bedside

Abstract

Background: Non-invasive assessment of neonatal hyperbilirubinemia is done clinically with the Kramer scale and transcutaneous bilirubinometer. Recently, the Stool color for Triage of Infants needing Phototherapy (STrIP) score was studied and found to be better than both of the above methods in predicting measured serum bilirubin. This study sheds light on the clinical utility of the STrIP score in making therapeutic decisions. Method: This was a prospective study done in a tertiary-level neonatal unit. Breastfed term babies with clinical jaundice were recruited. The Kramer scale and STrIP score were performed on them and compared with respect to the therapeutic decision of commencing phototherapy based on measured serum bilirubin. Results: One hundred and twenty-eight infants were studied. The Kramer scale correctly aided the therapeutic decision on phototherapy (either to start or not to start) in 47 (36.7%) and the STrIP score in 119 (93%) of our subjects ( p = .0001). In 81 (63.2%) of the subjects, the Kramer scale underestimated the need for phototherapy. In contrast, the STrIP score overestimated the need for phototherapy in 11 (9%). Conclusion: The STrIP score helps in making more accurate therapeutic decisions in neonatal hyperbilirubinemia compared to the Kramer scale alone with respect to commencing phototherapy.