BILIRUBIN/ALBUMIN RATIO USEFUL FOR MANAGEMENT OF CHRONIC NEUROLOGIC INJURIES OF HYPERBILIRUBINEMIA
Journal Title: World Journal of Pharmaceutical and Medical Research - Year 2018, Vol 4, Issue 3
Abstract
Objective: The aim of this study was to identify thresholds and evaluate sensitivity and specificity of bilirubin-albumin ratio (B/A) in comparison with total serum bilirubin (TSB) in predicting chronic neurologic and auditory impairment. Methods: Two hundreds term and near term neonates with severe hyperbilirubinemia were evaluated for bilirubin-induced neurologic dysfunction (BIND) by clinical findings at admission in Ghods children's hospital, Qazvin, Iran. During more than one-year follow up, permanent neurologic injuries and auditory impairment were evaluated by performing Auditory Brain stem Response (ABR) and serial clinical examinations. The relationship of B/A ratio and TSB to BIND were assessed by using receiver operating characteristic curves (ROC). Results: Chronic BIND developed in 5% neonates, concluding three frank kernicterus and seven-isolated auditory dysfunction. ROC analysis identified a TSB cutoff 22.7 mg/dl [area under the curve (AUC): 0.967] with a sensitivity of 100% and specificity of 88% and B/A ratio cutoff 5.6 [AUC: 0.953] with sensitivity of 100% and specificity of 75%. Conclusion: TSB is a stronger predictor of neurotoxicity than B/A ratio, but using combination of B/A ratio and TSB improves the sensitivity of predictions of BIND to 100%. Threshold values detecting all affected patients for B/A ratio (100% sensitivity) are lower in our study than recommended guideline.
Authors and Affiliations
Dr. Maryam Hosseinabadi
Keywords
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