Modified Kramer's versus Kramer's Method for Clinical Assessment of Jaundice in Term and Near-Term Neonates
© 2024. The Author(s), under exclusive licence to Dr. K C Chaudhuri Foundation..
OBJECTIVES: To compare the performance of Modified Kramer's and Kramer's methods in terms of agreement with total serum bilirubin (TSB).
METHODS: This cross-sectional study was done in Level-III neonatal unit in New Delhi. Visibly jaundiced neonates born at ≥35 wk of gestation were enrolled and examined by (i) conventional Kramer's, (ii) Modified Kramer's in artificial (MK-A) and (iii) natural daylight (MK-N), and finally sampled for estimation of TSB by point-of-care spectrophotometry. The primary outcomes were agreement of Kramer's and Modified Kramer's with TSB and accuracy in terms of proportion of bilirubin estimates lying within ±2 mg/dL of TSB; secondary outcome was agreement of MK-A and MK-N with TSB.
RESULTS: A total of 144 neonates with median gestation of 37 wk and mean birth weight of 2788 g were enrolled. Bland Altman analysis between Kramer's and TSB yielded mean difference of 1.7 mg/dL, 95% limits of agreement (LOA) -3.1 to 6.6 mg/dL. For Modified Kramer's and TSB, mean difference was -0.02 mg/dL, 95% LOA -4.7 to 4.7 mg/dL under artificial light; 0.02 mg/dL, 95% LOA -4.2 to 4.2 mg/dL under natural daylight. MK-N had highest proportion of bilirubin estimates lying within ±2 mg/dL of TSB (68.7%) as compared to MK-A (59.7%) [OR, 1.77; 95% CI, 1.09 to 2.86] and Kramer's (45.8%) [OR, 1.65; 95% CI, 1.27 to 2.15].
CONCLUSIONS: Though all the three methods had poor agreement with TSB, Modified Kramer's method when performed in natural light had reasonable accuracy, however limited clinical utility, in evaluation of clinical jaundice.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
|---|---|
| Enthalten in: |
Indian journal of pediatrics - (2024) vom: 12. Jan. |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Bansal, Shivam [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Clinical icterus |
|---|
| Anmerkungen: |
Date Revised 12.01.2024 published: Print-Electronic Citation Status Publisher |
|---|
| doi: |
10.1007/s12098-023-05000-1 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM367053810 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM367053810 | ||
| 003 | DE-627 | ||
| 005 | 20240114234708.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 240114s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1007/s12098-023-05000-1 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1257.xml |
| 035 | |a (DE-627)NLM367053810 | ||
| 035 | |a (NLM)38214829 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Bansal, Shivam |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Modified Kramer's versus Kramer's Method for Clinical Assessment of Jaundice in Term and Near-Term Neonates |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Revised 12.01.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a © 2024. The Author(s), under exclusive licence to Dr. K C Chaudhuri Foundation. | ||
| 520 | |a OBJECTIVES: To compare the performance of Modified Kramer's and Kramer's methods in terms of agreement with total serum bilirubin (TSB) | ||
| 520 | |a METHODS: This cross-sectional study was done in Level-III neonatal unit in New Delhi. Visibly jaundiced neonates born at ≥35 wk of gestation were enrolled and examined by (i) conventional Kramer's, (ii) Modified Kramer's in artificial (MK-A) and (iii) natural daylight (MK-N), and finally sampled for estimation of TSB by point-of-care spectrophotometry. The primary outcomes were agreement of Kramer's and Modified Kramer's with TSB and accuracy in terms of proportion of bilirubin estimates lying within ±2 mg/dL of TSB; secondary outcome was agreement of MK-A and MK-N with TSB | ||
| 520 | |a RESULTS: A total of 144 neonates with median gestation of 37 wk and mean birth weight of 2788 g were enrolled. Bland Altman analysis between Kramer's and TSB yielded mean difference of 1.7 mg/dL, 95% limits of agreement (LOA) -3.1 to 6.6 mg/dL. For Modified Kramer's and TSB, mean difference was -0.02 mg/dL, 95% LOA -4.7 to 4.7 mg/dL under artificial light; 0.02 mg/dL, 95% LOA -4.2 to 4.2 mg/dL under natural daylight. MK-N had highest proportion of bilirubin estimates lying within ±2 mg/dL of TSB (68.7%) as compared to MK-A (59.7%) [OR, 1.77; 95% CI, 1.09 to 2.86] and Kramer's (45.8%) [OR, 1.65; 95% CI, 1.27 to 2.15] | ||
| 520 | |a CONCLUSIONS: Though all the three methods had poor agreement with TSB, Modified Kramer's method when performed in natural light had reasonable accuracy, however limited clinical utility, in evaluation of clinical jaundice | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Clinical icterus | |
| 650 | 4 | |a Kramer’s method | |
| 650 | 4 | |a Neonatal hyperbilirubinemia | |
| 650 | 4 | |a Neonatal jaundice | |
| 650 | 4 | |a Visual assessment | |
| 700 | 1 | |a Kumar, Vivek |e verfasserin |4 aut | |
| 700 | 1 | |a Sharma, Akash |e verfasserin |4 aut | |
| 700 | 1 | |a Sankar, M J |e verfasserin |4 aut | |
| 700 | 1 | |a Thukral, Anu |e verfasserin |4 aut | |
| 700 | 1 | |a Verma, Ankit |e verfasserin |4 aut | |
| 700 | 1 | |a Agarwal, Ramesh |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Indian journal of pediatrics |d 1945 |g (2024) vom: 12. Jan. |w (DE-627)NLM000070742 |x 0973-7693 |7 nnns |
| 773 | 1 | 8 | |g year:2024 |g day:12 |g month:01 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1007/s12098-023-05000-1 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |j 2024 |b 12 |c 01 | ||