Kramer Score, an Evidence of Its Use in Accordance with Indonesian Hyperbilirubinemia Published Guideline

Mahendra Tri Arif Sampurna, Muhammad Pradhika Mapindra, Muhammad Pradhiki Mahindra, Kinanti Ayu Ratnasari, Siti Annisa Dewi Rani, Kartika Darma Handayani, Dina Angelika, Agus Harianto, Martono Tri Utomo, Risa Etika and Pieter J. J. Sauer
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Mahendra Tri Arif Sampurna: Neonatology Division, Department of Pediatrics, Dr. Soetomo Academic Teaching Hospital, Faculty of Medicine, Universitas Airlangga, Surabaya 60285, Indonesia
Muhammad Pradhika Mapindra: Neonatal Research Group Surabaya, Faculty of Medicine, Universitas Airlangga, Surabaya 60285, Indonesia
Muhammad Pradhiki Mahindra: Neonatal Research Group Surabaya, Faculty of Medicine, Universitas Airlangga, Surabaya 60285, Indonesia
Kinanti Ayu Ratnasari: Neonatal Research Group Surabaya, Faculty of Medicine, Universitas Airlangga, Surabaya 60285, Indonesia
Siti Annisa Dewi Rani: Neonatal Research Group Surabaya, Faculty of Medicine, Universitas Airlangga, Surabaya 60285, Indonesia
Kartika Darma Handayani: Neonatology Division, Department of Pediatrics, Dr. Soetomo Academic Teaching Hospital, Faculty of Medicine, Universitas Airlangga, Surabaya 60285, Indonesia
Dina Angelika: Neonatology Division, Department of Pediatrics, Dr. Soetomo Academic Teaching Hospital, Faculty of Medicine, Universitas Airlangga, Surabaya 60285, Indonesia
Agus Harianto: Neonatology Division, Department of Pediatrics, Dr. Soetomo Academic Teaching Hospital, Faculty of Medicine, Universitas Airlangga, Surabaya 60285, Indonesia
Martono Tri Utomo: Neonatology Division, Department of Pediatrics, Dr. Soetomo Academic Teaching Hospital, Faculty of Medicine, Universitas Airlangga, Surabaya 60285, Indonesia
Risa Etika: Neonatology Division, Department of Pediatrics, Dr. Soetomo Academic Teaching Hospital, Faculty of Medicine, Universitas Airlangga, Surabaya 60285, Indonesia
Pieter J. J. Sauer: Department of Pediatrics, Beatrix Children’s Hospital, University Medical Center Groningen, University of Groningen, 9713GZ Groningen, The Netherlands

IJERPH, 2021, vol. 18, issue 11, 1-8

Abstract: Background: In some hospitals in low/middle-income countries, methods to determine the bilirubin level in newborn infants are unavailable and based on a clinical evaluation, namely a clinical score designed by Kramer. In this study, we evaluated if this score can be used to identify those infants that need phototherapy. Method: Infants admitted between November 2018 and June 2019 to three hospitals in Surabaya, Indonesia were included. The jaundice intensity was scored using the Kramer score. Blood was sampled for total serum bilirubin (TSB) measurement. The infants were categorized into Treatment Needed (TN) group when treatment with phototherapy was indicated and the No Treatment Needed (NTN) group when phototherapy was not indicated, based on the Indonesian Guideline for hyperbilirubinemia. Result: A total of 280 infants with a mean birth weight of 2744.6 ± 685.8 g and a gestational age of 37.3 ± 2.3 weeks were included. Twenty-seven of 113 (24%) infants with Kramer score 2 needed phototherapy, compared with 41 of 90 (46%) infants with score 3 and 20 of 28 (71%) of infants with score 4. The percentage of infants that needed phototherapy was higher with decreasing gestational age. Conclusion: The Kramer score is an invalid method to distinguish between those infants needing phototherapy and those infants where this treatment is not indicated.

Keywords: hyperbilirubinemia; Kramer score; Indonesia guideline; phototherapy; reliability (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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