Abstract
BACKGROUND: The Clinical Risk Index for Babies II (CRIB II) is a validated scoring system for predicting early mortality risk among low birth weight (LBW) preterm neonates. However, its routine use remains limited in many developing countries. This study aimed to evaluate the effectiveness of the CRIB II score in predicting neonatal mortality among LBW infants admitted to a tertiary care Neonatal Intensive Care Unit (NICU). METHODS: This prospective cohort study included 140 preterm neonates (gestational age 23-32 weeks) admitted to the NICU within 24 hours of birth. Baseline demographic variables, clinical characteristics, and CRIB II scores were recorded Neonatal outcomes were followed until discharge or death. Diagnostic performance was assessed using sensitivity, specificity, predictive values, accuracy, and receiver operating characteristic (ROC) curve analysis. RESULTS: There was a slight male predominance (51%). The mean birth weight was 1550.97 ± 253.58 g, and the mean gestational age was 30.42 ± 2.23 weeks. Overall neonatal mortality was 32.85%. Mortality increased progressively with higher CRIB II scores: 0% in level I, 3.84% in level II, 64.70% in level III, and 100% in level IV. The CRIB II score demonstrated excellent predictive performance with a sensitivity of 84.78%, specificity of 90.42%, and diagnostic accuracy of 88.57%. CONCLUSION: The CRIB II score is a reliable and effective tool for early prediction of neonatal mortality in LBW preterm infants and should be considered for routine risk stratification in NICU settings.