OBJECTIVE To compare the prognostic accuracy of six neonatal illness severity scores (CRIB, CRIB II, SNAP, SNAP II, SNAP-PE, and SNAP-PE II), birthweight (BW), and gestational age (GA) for predicting pre-discharge mortality among very low birth weight (VLBW) infants (<1500 g) and very preterm infants (<32 weeks' gestational age). STUDY DESIGN PubMed, EMBASE, and Scopus were the data sources searched for studies published before January 2019. Data were extracted, pooled, and analyzed using random-effects models and reported as AUC with 95% confidence intervals (CI). RESULTS Of 1659 screened studies, 24 met inclusion criteria. CRIB was the most discriminate for predicting pre-discharge mortality [AUC 0.88 (0.86-0.90)]. GA was the least discriminate [AUC 0.76 (0.72-0.80)]. CONCLUSIONS Although the original CRIB score was the most accurate predictor of pre-discharge mortality, significant heterogeneity between studies lowers confidence in this pooled estimate. A more precise illness severity score to predict pre-discharge mortality is still needed.

中文翻译：

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比较 VLBW 和早产儿的死亡风险模型：系统评价和荟萃分析。

目的 比较六种新生儿疾病严重程度评分（CRIB、CRIB II、SNAP、SNAP II、SNAP-PE 和 SNAP-PE II）、出生体重 (BW) 和胎龄 (GA) 对预测出院前的预后准确性极低出生体重 (VLBW) 婴儿 (<1500 g) 和极早产儿 (<32 周胎龄) 的死亡率。研究设计 PubMed、EMBASE 和 Scopus 是搜索 2019 年 1 月之前发表的研究的数据源。使用随机效应模型提取、汇总和分析数据，并报告为具有 95% 置信区间 (CI) 的 AUC。结果 在 1659 项筛选研究中，24 项符合纳入标准。CRIB 在预测出院前死亡率 [AUC 0.88 (0.86-0.90)] 方面最具辨别力。GA 的区分度最低 [AUC 0.76 (0.72-0.80)]。结论 尽管最初的 CRIB 评分是出院前死亡率的最准确预测指标，但研究之间的显着异质性降低了这一汇总估计的可信度。仍然需要更精确的疾病严重程度评分来预测出院前死亡率。