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Volume 18
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Article

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

by
Mahendra Tri Arif Sampurna
1,2,*,
Muhammad Pradhika Mapindra
3,
Muhammad Pradhiki Mahindra
3,
Kinanti Ayu Ratnasari
3,
Siti Annisa Dewi Rani
3,
Kartika Darma Handayani
1,
Dina Angelika
1,
Agus Harianto
1,
Martono Tri Utomo
1,
Risa Etika
1 and
Pieter J. J. Sauer
4
1
Neonatology Division, Department of Pediatrics, Dr. Soetomo Academic Teaching Hospital, Faculty of Medicine, Universitas Airlangga, Surabaya 60285, Indonesia
2
Neonatology Division, Department of Pediatrics, Airlangga University Teaching Hospital, Faculty of Medicine, Universitas Airlangga, Surabaya 60115, Indonesia
3
Neonatal Research Group Surabaya, Faculty of Medicine, Universitas Airlangga, Surabaya 60285, Indonesia
4
Department of Pediatrics, Beatrix Children’s Hospital, University Medical Center Groningen, University of Groningen, 9713GZ Groningen, The Netherlands
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2021, 18(11), 6173; https://doi.org/10.3390/ijerph18116173
Submission received: 30 March 2021 / Revised: 11 May 2021 / Accepted: 27 May 2021 / Published: 7 June 2021
(This article belongs to the Section Children's Health)
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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 hyperbilirubinemia; Kramer score; Indonesia guideline; phototherapy; reliability

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MDPI and ACS Style

Sampurna, M.T.A.; Mapindra, M.P.; Mahindra, M.P.; Ratnasari, K.A.; Rani, S.A.D.; Handayani, K.D.; Angelika, D.; Harianto, A.; Utomo, M.T.; Etika, R.; et al. Kramer Score, an Evidence of Its Use in Accordance with Indonesian Hyperbilirubinemia Published Guideline. Int. J. Environ. Res. Public Health 2021, 18, 6173. https://doi.org/10.3390/ijerph18116173

AMA Style

Sampurna MTA, Mapindra MP, Mahindra MP, Ratnasari KA, Rani SAD, Handayani KD, Angelika D, Harianto A, Utomo MT, Etika R, et al. Kramer Score, an Evidence of Its Use in Accordance with Indonesian Hyperbilirubinemia Published Guideline. International Journal of Environmental Research and Public Health. 2021; 18(11):6173. https://doi.org/10.3390/ijerph18116173

Chicago/Turabian Style

Sampurna, Mahendra Tri Arif, 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 et al. 2021. "Kramer Score, an Evidence of Its Use in Accordance with Indonesian Hyperbilirubinemia Published Guideline" International Journal of Environmental Research and Public Health 18, no. 11: 6173. https://doi.org/10.3390/ijerph18116173

APA Style

Sampurna, M. T. A., Mapindra, M. P., Mahindra, M. P., Ratnasari, K. A., Rani, S. A. D., Handayani, K. D., Angelika, D., Harianto, A., Utomo, M. T., Etika, R., & Sauer, P. J. J. (2021). Kramer Score, an Evidence of Its Use in Accordance with Indonesian Hyperbilirubinemia Published Guideline. International Journal of Environmental Research and Public Health, 18(11), 6173. https://doi.org/10.3390/ijerph18116173

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