Diagnostic Accuracy of Kramer Visual Assessment of Jaundice in Term Neonates Taking Total Serum Bilirubin Levels as the Gold Standard

Shaista Mumtaz; Muhammad Faisal Shafiq; Kenan Anwar Khan; Murtaza Hussain; Asbah Rahman; Sania Shafiq

doi:10.51253/pafmj.v72i6.6252

Authors

Shaista Mumtaz Pak Emirates Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Muhammad Faisal Shafiq Combined Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Kenan Anwar Khan Combined Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Murtaza Hussain Combined Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Asbah Rahman Combined Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Sania Shafiq Pakistan Institute of Medical Sciences, Islamabad Pakistan

DOI:

https://doi.org/10.51253/pafmj.v72i6.6252

Keywords:

Kramer visual assessment, Neonates, Total serum bilirubin

Abstract

Objective: To determine the Diagnostic accuracy of Kramer's visual assessment of jaundice in term neonates by taking total serum bilirubin levels as a gold standard.

Study Design: Cross-sectional study.

Place and Duration of Study: Neonatology Department, Pak Emirates Military Hospital, Rawalpindi Pakistan, Mar to Sep 2019.

Methodology: The study was based on examining and investigating 300 neonates. Kramer scale was used to examine jaundice in all neonates, and results were compared to total serum bilirubin levels.

Results: A total of 300 patients were included in this study. The mean bilirubin level was 229.1±74.5mol/L. The sensitivity and specificity of visual assessment of jaundice using the Kramer visual scale were 83.84% and 73.53%, respectively, for neonates who were not jaundiced below the abdomen and thighs included in Kramer zones 1 to 3.

Conclusion: Kramer visual assessment can be used as a noninvasive screening method in neonates jaundiced up to the abdomen and thighs, which is included in Kramer zones 1 to 3 but for markedly jaundiced neonates Kramer scale is not a reliable noninvasive method of bilirubin estimation.