| Autor: |
Xue GC; Department of Pediatrics, Wuxi 9th People's Hospital Affiliated to Soochow University, Wuxi 214062, China., Zhang HL; Department of Pediatrics, Zhenping People's Hospital, Nanyang 474250, China., Ding XX; Department of Pediatrics, the People's Hospital of Anyang City, Anyang 455000, China., Xiong F; Department of Pediatrics, Sichuan Provincial Hospital for Women and Children, Chengdu 610045, China., Liu YH; Department of Neonatal, People's Hospital of Zhengzhou, Zhengzhou 450003, China., Peng H; Department of Pediatrics, the Third People's Hospital of Jingzhou, Jingzhou 434001, China., Wang CL; Department of Neonatal, Affiliated Children's Hospital of Jiangnan University, Wuxi 214023, China., Zhao Y; Department of Neonatal, Kaifeng Maternal and Child Health Hospital, Kaifeng 475002, China., Yan HL; Department of Neonatal, Jiaozuo Maternal and Child Health Hospital, Jiaozuo 454001, China., Ren MX; Department of Pediatrics, Wuxi 9th People's Hospital Affiliated to Soochow University, Wuxi 214062, China., Ma CY; Department of Pediatrics, Wuxi 9th People's Hospital Affiliated to Soochow University, Wuxi 214062, China., Lu HM; Department of Pediatrics, Wuxi 9th People's Hospital Affiliated to Soochow University, Wuxi 214062, China., Li YL; Department of Pediatrics, Zhenping People's Hospital, Nanyang 474250, China., Meng RF; Department of Pediatrics, Zhenping People's Hospital, Nanyang 474250, China., Xie LJ; Department of Pediatrics, Zhenping People's Hospital, Nanyang 474250, China., Chen N; Department of Pediatrics, the People's Hospital of Anyang City, Anyang 455000, China., Cheng XF; Department of Pediatrics, the People's Hospital of Anyang City, Anyang 455000, China., Wang JJ; Department of Pediatrics, the People's Hospital of Anyang City, Anyang 455000, China., Xin XH; Department of Pediatrics, the People's Hospital of Anyang City, Anyang 455000, China., Wang RF; Department of Pediatrics, the People's Hospital of Anyang City, Anyang 455000, China., Jiang Q; Department of Pediatrics, Sichuan Provincial Hospital for Women and Children, Chengdu 610045, China., Zhang Y; Department of Pediatrics, Sichuan Provincial Hospital for Women and Children, Chengdu 610045, China., Liang GJ; Department of Neonatal, People's Hospital of Zhengzhou, Zhengzhou 450003, China., Li YZ; Department of Neonatal, People's Hospital of Zhengzhou, Zhengzhou 450003, China., Kang JN; Department of Neonatal, People's Hospital of Zhengzhou, Zhengzhou 450003, China., Zhang HM; Department of Neonatal, People's Hospital of Zhengzhou, Zhengzhou 450003, China., Zhang YY; Department of Pediatrics, the Third People's Hospital of Jingzhou, Jingzhou 434001, China., Yuan Y; Department of Pediatrics, the Third People's Hospital of Jingzhou, Jingzhou 434001, China., Li YW; Department of Neonatal, Affiliated Children's Hospital of Jiangnan University, Wuxi 214023, China., Su YL; Department of Neonatal, Affiliated Children's Hospital of Jiangnan University, Wuxi 214023, China., Liu JP; Department of Neonatal, Kaifeng Maternal and Child Health Hospital, Kaifeng 475002, China., Duan SJ; Department of Neonatal, Kaifeng Maternal and Child Health Hospital, Kaifeng 475002, China., Liu QS; Department of Neonatal, Jiaozuo Maternal and Child Health Hospital, Jiaozuo 454001, China., Wei J; Department of Neonatal, Jiaozuo Maternal and Child Health Hospital, Jiaozuo 454001, China. |
| Abstrakt: |
Objective: To evaluate the diagnostic efficacy and practicality of the Jaundice color card (JCard) as a screening tool for neonatal jaundice. Methods: Following the standards for reporting of diagnostic accuracy studies (STARD) statement, a multicenter prospective study was conducted in 9 hospitals in China from October 2019 to September 2021. A total of 845 newborns who were admitted to the hospital or outpatient department for liver function testing due to their own diseases. The inclusion criteria were a gestational age of ≥35 weeks, a birth weight of ≥2 000 g, and an age of ≤28 days. The neonate's parents used the JCard to measure jaundice at the neonate's cheek. Within 2 hours of the JCard measurement, transcutaneous bilirubin (TcB) was measured with a JH20-1B device and total serum bilirubin (TSB) was detected. The Pearson's correlation analysis, Bland-Altman plots and the receiver operating characteristic (ROC) curve were used for statistic analysis. Results: Out of the 854 newborns, 445 were male and 409 were female; 46 were born at 35-36 weeks of gestational age and 808 were born at ≥37 weeks of gestational age. Additionally, 432 cases were aged 0-3 days, 236 cases were aged 4-7 days, and 186 cases were aged 8-28 days. The TSB level was (227.4±89.6) μmol/L, with a range of 23.7-717.0 μmol/L. The JCard level was (221.4±77.0) μmol/L and the TcB level was (252.5±76.0) μmol/L. Both the JCard and TcB values showed good correlation ( r =0.77 and 0.80, respectively) and agreements (96.0% (820/854) and 95.2% (813/854) of samples fell within the 95% limits of agreement, respectively) with TSB. The JCard value of 12 had a sensitivity of 0.93 and specificity of 0.75 for identifying a TSB ≥205.2 μmol/L, and a sensitivity of 1.00 and specificity of 0.35 for identifying a TSB ≥342.0 μmol/L. The TcB value of 205.2 μmol/L had a sensitivity of 0.97 and specificity of 0.60 for identifying TSB levels of 205.2 μmol/L, and a sensitivity of 1.00 and specificity of 0.26 for identifying TSB levels of 342.0 μmol/L. The areas under the ROC curve (AUC) of JCard for identifying TSB levels of 153.9, 205.2, 256.5, and 342.0 μmol/L were 0.96, 0.92, 0.83, and 0.83, respectively. The AUC of TcB were 0.94, 0.91, 0.86, and 0.87, respectively. There were both no significant differences between the AUC of JCard and TcB in identifying TSB levels of 153.9 and 205.2 μmol/L (both P> 0.05). However, the AUC of JCard were both lower than those of TcB in identifying TSB levels of 256.5 and 342.0 μmol/L (both P <0.05). Conclusions: JCard can be used to classify different levels of bilirubin, but its diagnostic efficacy decreases with increasing bilirubin levels. When TSB level are ≤205.2 μmol/L, its diagnostic efficacy is equivalent to that of the JH20-1B. To prevent the misdiagnosis of severe jaundice, it is recommended that parents use a low JCard score, such as 12, to identify severe hyperbilirubinemia (TSB ≥342.0 μmol/L). |
