Chang et al reported a clinical prediction rule (CPR) for rebound hyperbilirubinemia in a neonate treated with inpatient phototherapy. This can help to identify a patient who may benefit from more aggressive management. The authors are from Seattle Children's Hospital, Kaiser Permanente Northern California and University of California San Francisco.
Patient selection: neonate with hyperbilirubinemia who has undergone inpatient phototherapy
Outcome: rebound of total serum bilirubin to phototherapy threshold within 72 hours
Parameters:
(1) gestational age in weeks
(2) age at phototherapy initiation in days
(3) total serum bilirubin in mg/dL relative to the treatment threshold at phototherapy termination
Parameter
Finding
Points
gestational age
< 38 weeks
15
>= 38 weeks
0
age in days at start of phototherapy
- 7 * (days)
total serum bilirubin TSB) at phototherapy termination
4 * ((TSB) - (phototherapy threshold)))
prediction score =
= SUM(points for all of the parameters) + 50
Interpretation:
• The higher the score the greater the risk of rebound hyperbilirubinemia.
Prediction Score
Rebound Hyperbilirubinemia
<= 9
0.3%
10 to 19
1.8 to 2.8%
20 to 29
4.8 to 6.1%
30 to 39
17 to 18%
40 to 49
26 to 30%
>= 50
41 to 49%
To read more or access our algorithms and calculators, please log in or register.