Asker Hüseyin Selim, Satar Mehmet, Yıldızdaş Hacer Yapıcıoğlu, Mutlu Birgül, Özyurt Banu Mutlu, İpek Mehmet Şah, Sivaslı Ercan, Taviloğlu Şafak, Çelik Yalçın, Özcan Kenan, Burgut Refik, Ünal İlker
Department of Pediatrics, Division of Neonatology, Çukurova University, Adana, Turkey.
Neonatal Intensive Care Unit, Diyarbakır Children's Hospital, Diyarbakır, Turkey.
Pediatr Int. 2016 Oct;58(10):984-987. doi: 10.1111/ped.12973. Epub 2016 Jun 21.
The aim of this study was to determine mortality risk by calculating Score for Neonatal Acute Physiology and Perinatal Extension II (SNAP-PE-II) and Clinical Risk Index for Babies (CRIB) score, and evaluate prediction of the effects of antenatal corticosteroid and surfactant treatment on mortality.
This multicenter study was conducted simultaneously in five different centers in four different provinces in Southern Turkey between July 2012 and July 2013. A total of 1668 inborn subjects hospitalized in the neonatal intensive care unit within the first 12 h of delivery, and meeting the selection criteria, were included in the study, and CRIB and SNAP-PE-II were used to determine mortality.
The SNAP-PE-II scoring system was applied to all patients, and the CRIB scoring system was used for 310 newborns with gestational age <32 weeks and weighing <1500 g. Of the 1668 patients, 188 died (mortality rate, 11.3%). Cut-off was found to vary with center, which changed specificity and sensitivity of the mortality scores. SNAP-PE-II significantly predicted mortality (P < 0.05) compared with CRIB. SNAP-PE-II also successfully predicted mortality in the group receiving antenatal corticosteroid compared with the group not receiving antenatal corticosteroid.
SNAP-PE-II was a significant predictor of mortality in newborns with birthweight <1500 g compared with CRIB, and assessment of antenatal corticosteroid use in conjunction with SNAP-PE-II increased the accuracy of the prediction of mortality.
本研究的目的是通过计算新生儿急性生理学及围生期扩展Ⅱ评分（SNAP-PE-II）和婴儿临床风险指数（CRIB）评分来确定死亡风险，并评估产前使用皮质类固醇和表面活性剂治疗对死亡率的预测作用。
2012年7月至2013年7月期间，在土耳其南部四个不同省份的五个不同中心同时进行了这项多中心研究。共有1668名出生后12小时内入住新生儿重症监护病房且符合入选标准的足月儿被纳入研究，采用CRIB和SNAP-PE-II来确定死亡率。
对所有患者应用了SNAP-PE-II评分系统，对310名胎龄<32周且体重<1500 g的新生儿使用了CRIB评分系统。1668例患者中，188例死亡（死亡率为11.3%）。发现临界值因中心而异，这改变了死亡评分的特异性和敏感性。与CRIB相比，SNAP-PE-II能显著预测死亡率（P<0.05）。与未接受产前皮质类固醇治疗的组相比，SNAP-PE-II也成功预测了接受产前皮质类固醇治疗组的死亡率。
与CRIB相比，SNAP-PE-II是出生体重<1500 g新生儿死亡率的显著预测指标，结合SNAP-PE-II评估产前皮质类固醇的使用可提高死亡率预测的准确性。
