尼泊尔资源有限的新生儿重症监护病房的死亡预测

Predicting deaths in a resource-limited neonatal intensive care unit in Nepal.

作者信息

Shrestha Dhruba, Dhoubhadel Bhim G, Parry Christopher M, Prajapati Bina, Ariyoshi Koya, Mahaseth Chandeshwar

机构信息

Siddhi Memorial Hospital, Siddhi Memorial Foundation, Bhaktapur, P.O. Box 40.

Kanti Children's Hospital, Maharajgunj, Kathmandu-3, Nepal.

出版信息

Trans R Soc Trop Med Hyg. 2017 Jul 1;111(7):287-293. doi: 10.1093/trstmh/trx053.

DOI:10.1093/trstmh/trx053

PMID:29029328

Abstract

BACKGROUND

This study aimed to determine whether the Neonatal Acute Physiology (SNAP) scoring system (SNAP II) and with perinatal extension (SNAP II PE) can be used to predict neonatal deaths in a resource-limited neonatal intensive care unit in Nepal.

METHODS

A prospective observational study was conducted in a neonatal intensive care unit (NICU) of Kanti Children's Hospital in Kathmandu, Nepal. Data required for the SNAP II and SNAP II PE scores were collected. The relationships between the SNAP II and SNAP II PE scores and neonatal mortality were analyzed.

RESULTS

There were 135 neonates admitted during the 6 month study period, of whom 126 met the inclusion criteria. Of these 126 neonates, 29 (23.0%) died. Mortality was 83% (5/6) when SNAP II was >40, and 66.7% (6/9) when SNAP II PE was >50. A SNAP II score of ≥12 had a sensitivity of 75.9%, and specificity of 73.2% for predicting mortality, and a SNAP II PE score of ≥14 had a sensitivity of 82.8% and specificity of 67.0% for it.

CONCLUSIONS

SNAP II and SNAP II PE scoring of neonates can be used to predict prognosis of neonates in resource-limited NICUs in Nepal.

摘要

背景

本研究旨在确定新生儿急性生理学（SNAP）评分系统（SNAP II）及围产期扩展版（SNAP II PE）能否用于预测尼泊尔资源有限的新生儿重症监护病房中的新生儿死亡情况。

方法

在尼泊尔加德满都坎蒂儿童医院的新生儿重症监护病房（NICU）开展了一项前瞻性观察性研究。收集了SNAP II和SNAP II PE评分所需的数据。分析了SNAP II和SNAP II PE评分与新生儿死亡率之间的关系。

结果

在为期6个月的研究期间，共有135名新生儿入院，其中126名符合纳入标准。在这126名新生儿中，29名（23.0%）死亡。当SNAP II>40时，死亡率为83%（5/6）；当SNAP II PE>50时，死亡率为66.7%（6/9）。SNAP II评分≥12预测死亡率的敏感度为75.9%，特异度为73.2%；SNAP II PE评分≥14预测死亡率的敏感度为82.8%，特异度为67.0%。