Utilization of SNAP II and SNAPPE II Scores for Predicting the Mortality Rate Among a Cohort of Iranian Newborns.

BACKGROUND

The present study was conducted to determine the utility of Score for Neonatal Acute Physiology II (SNAP II) and Score for Neonatal Acute Physiology with Perinatal Extension II (SNAPPE II) scoring systems as predictors of neonatal mortality rate, and to compare the predictive value of these two methods.

METHODS

In this prospective study data were gathered from infants admitted to the neonatal intensive care unit (NICU) of Imam Hossein Medical Center, Tehran, Iran, from March 2015 to December 2015. In addition to demographic data, Apgar score at 5 minutes after birth, initial and final diagnosis, SNAP II, and SNAPPE II were recorded within 24 hours after admission to the NICU.

RESULTS

One hundred ninety-one newborn infants entered into the study. Birth weight (2555 ± 722 g in survival group versus 1588 ± 860 g in expired group, P<0.001), and Apgar score more than 7 at 5 minutes after birth (99.4% in survival group versus 57.1% in expired group, P<0.001) were significantly related to the mortality rate. By analyzing the data using logistic regression, it was found that SNAP II (area under the curve [AUC] = 0.992; 95% CI: 0.98-1) and SNAPPE II (AUC = 0.994; 95% CI: 0.984-1)had better value for predicting the patients' survival compared to Apgar score at 5 minutes after birth (AUC = 0.711; 95% CI: 0.568-0.855). There was no statistically significant difference in predictive value of SNAP II and SNAPPE II methods (P>0.99).

CONCLUSION

According to our findings SNAP II and SNAPPE II are useful tools in predicting the mortality rate among Iranian neonates admitted to NICU. Although there was no significant difference between SNAP II and SNAPPE II, both methods had a much better predictive value compared to Apgar score at 5 minutes after birth.