Abstract 4

Background: It has been suggested that elevation of serum CKBB can be used to predict later neurological problems following a brain insult. For the past decade we have measured serum CKBB activity on the first day of life in infants with perinatal asphyxia. Aims: We planned to compare serum CKBB activity with Sarnat's score to discover which was most accurate at predicting adverse neurological outcome. Methods: Outcomes were assessed from the case records by neonatologists blinded to the CKBB results. Poor neurological outcome was defined as developmental delay, cerebral palsy, visual problems, deafness or death from perinatal asphyxia. Severe HIE was defined as Sarnat stage 3 or stage 2 for > 5 days. An optimum cut-off level for CKBB was obtained using a ROC curve The tests were compared using sensitivity, specificity, positive predictive value (PPV) and likelihood ratios. Results: 108 infants from a nine year period were identified 5 had died from perinatal asphyxia and 15 of the survivors were found to have neurological or developmental problems. The optimal discriminating value for CKBB was 70 IU/L. Using CKBB >70 or severe HIE to predict adverse outcome gave the following results.Table Conclusion: CKBB serves as a marker of perinatal asphyxia, but is less accurate than the Sarnat score for predicting adverse neurological outcome.

Table 1
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