Race, gender, and clinical risk index for babies (CRIB) score as predictors of severe retinopathy of prematurity.
OBJECTIVE
To determine whether race, gender, and the Clinical Risk Index for Babies (CRIB) illness severity score are predictors of threshold or severe prethreshold retinopathy of prematurity warranting surgery (ROP warranting surgery) and whether racial and gender differences in ROP are correlated with racial and gender differences in illness severity.


METHODS
This was a retrospective analysis of premature infants 401-1250 g at birth that were admitted to the University Hospital of Cincinnati (January 1998 to May 2003). Birth weight, gestational age, multiple birth, birth in the study hospital or elsewhere, race, gender, CRIB score, and eye findings were abstracted. The outcome variable was ROP warranting surgery.


RESULTS
Of 299 patients (596 eyes) with adequate eye and CRIB data, 35 patients (11.7%) [66 eyes; 11.1%] developed ROP warranting surgery. Multiple logistic regression analysis showed that higher CRIB score (P < 0.0001; odds ratio [OR] 1.21), male gender (P < 0.005; OR: 2.68), nonblack race (P < 0.0005; OR: 4.32), lower gestational age, and multiple birth are predictive factors for ROP warranting surgery. Because birth weight and gestational age comprise 2 of the 6 components of the CRIB score, a CRIB subscore (CRIBSUB) consisting of the remaining 4 components was tested and remained a significant predictor (P < 0.00001). Birth weight was a significant predictor when CRIBSUB was in the model but not when the CRIB score was used. The CRIB score was a predictor of neonatal mortality, but race and gender did not predict the CRIB score or neonatal mortality.


CONCLUSIONS
Nonblack race, male gender, and higher CRIB illness severity scores are predictors of ROP warranting surgery. In our population, there were no racial or gender differences in neonatal mortality or CRIB scores to explain the racial and gender differences in severity of ROP.
Yang
Michael B
MB
Department of Ophthalmology/Abrahamson Pediatric Eye Institute, Cincinnati, Ohio 45229-3039, USA. Micheal.Yang@cchmc.org
Donovan
Edward F
EF
Wagge
Jordan R
JR
D001724:Birth Weight; D005260:Female; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D008297:Male; D044469:Racial Groups; D012044:Regression Analysis; D012160:Retina / Q000473:pathology; D012178:Retinopathy of Prematurity / Q000175:diagnosis / Q000208:ethnology*; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D014481:United States / Q000453:epidemiology