World Journal of Pharmaceutical
and Medical Research

( An ISO 9001:2015 Certified International Journal )

An International Peer Reviewed Journal for Pharmaceutical and Medical Research and Technology
An Official Publication of Society for Advance Healthcare Research (Reg. No. : 01/01/01/31674/16)
ISSN 2455-3301
IMPACT FACTOR: 6.842

ICV : 78.6

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Abstract

BILIRUBIN/ALBUMIN RATIO USEFUL FOR MANAGEMENT OF CHRONIC NEUROLOGIC INJURIES OF HYPERBILIRUBINEMIA

Dr. Morteza Habibi and Dr. Maryam Hosseinabadi*

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.

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