bhutani_nomogram_risk: Hour-Specific Risk for Neonatal Hyperbilirubinemia (Bhutani...

In cliot: Clinical Indices and Outcomes Tools

Hour-Specific Risk for Neonatal Hyperbilirubinemia (Bhutani Nomogram)

Description

Calculates the risk zone for neonatal hyperbilirubinemia based on the Bhutani Nomogram. This tool assesses the risk of developing severe hyperbilirubinemia in infants >= 35 weeks gestational age and birth weight >= 2000g or >= 2500g depending on specific guideline versions. It uses postnatal age in hours and Total Serum Bilirubin (TSB) to stratify infants into Low, Low-Intermediate, High-Intermediate, or High Risk zones.

Usage

bhutani_nomogram_risk(age_hours, total_bilirubin, units = "mg/dL")

Arguments

age_hours	Numeric. Postnatal age of the infant in hours. (Valid range typically 12-144+ hours).
total_bilirubin	Numeric. Total Serum Bilirubin level.
units	String. Units for the bilirubin input. Options: "mg/dL" (default) or "umol/L".

Value

A list containing:

Risk_Zone	The determined risk category (e.g., "High Intermediate Risk Zone").
TSB_mg_dL	The patient's bilirubin standardized to mg/dL.
Thresholds_at_Hour	The calculated 40th, 75th, and 95th percentile bilirubin values for the specific hour provided.

References

Bhutani VK, Johnson L, Sivieri EM. Predictive ability of a predischarge hour-specific serum bilirubin for subsequent significant hyperbilirubinemia in healthy term and near-term newborns. Pediatrics. 1999;103(1):6-14. doi:10.1542/peds.103.1.6

Examples

# Example 1: High Risk
# 24 hours old, Bilirubin 9.0 mg/dL (High Risk starts > ~8.0)
bhutani_nomogram_risk(24, 9.0)

# Example 2: Low Risk
# 48 hours old, Bilirubin 6.0 mg/dL (< 40th percentile of ~9.3)
bhutani_nomogram_risk(48, 6.0)

cliot documentation built on Dec. 1, 2025, 1:06 a.m.