David G. Sweet, Angela H. Bell, Garth McClure, Ian J. C. Wallace, Michael D. Shields
Comparison between creatine kinase brain isoenzyme (CKBB) activity and Sarnat score for prediction of adverse outcome following perinatal asphyxia
Aim: To assess whether plasma creatine kinase brain
isoenzyme (CKBB) levels or Sarnat scores are more accurate
for prediction of poor neurological outcome in
babies with suspected birth asphyxia.
Methods: In a retrospective study of 97 babies CKBB
levels were compared to the presence of severe hypoxic
ischaemic encephalopathy (HIE) as a predictive test for
these outcomes: developmental delay, cerebral palsy, visual
problems, deafness or death from perinatal asphyxia.
The tests were compared using positive predictive
values (PPV) and likelihood ratios (LR) with confidence
intervals (CI)
Results: 3 babies had died from perinatal asphyxia and
14 survivors were found to have neurological or developmental
problems. CKBB was elevated in babies with severe
HIE (p=0.0004). A receiver operator characteristic
(ROC) curve showed the optimal discriminating value
for CKBBto be 21 IU/L but theCKBB was a poor predictive
test. For prediction of adverse outcome: CKBB > 21
sensitivity 76?, specificity 40?, PPV 21? and LR 1.3
(95? CI 0.8–1.7). Severe HIE sensitivity 53?, specificity
95?, PPV 69? and LR 10.6 (95? CI 3.8–29.2).
Conclusion: CKBB is elevated following birth asphyxia
but is a poor predictor of adverse neurological
outcome.
Journal of Perinatal Medicine, Walter de Gruyter
Print ISSN: 1619-3997
Volume: 27, 12/1999
Pages: 478 - 483
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