Department of Pediatrics, B.P, Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal.
Department of Pediatrics, University College of Medical sciences, New Delhi, India.
BMC Pediatr. 2019 Aug 13;19(1):279. doi: 10.1186/s12887-019-1660-y.
There are many scoring systems to predict neonatal mortality and morbidity in neonatal intensive care units (NICU). One of the scoring systems is SNAPPE-II (Score for Neonatal Acute Physiology with Perinatal extension-II). This study was carried out to assess the validity of SNAPPE-II score (Score for Neonatal Acute Physiology with Perinatal Extension-II) as a predictor of neonatal mortality and duration of stay in a neonatal intensive care unit (NICU).
This prospective, observational study was carried out over a period of 12 months from June 2015 to May 2016. Two hundred fifty five neonates, who met the inclusion criteria admitted to NICU in tertiary care hospital, BPKIHS Hospital, Nepal were enrolled in the study and SNAPPE-II score was calculated. Receiver Operating Characteristic (ROC) curve was constructed to derive the best SNAPPE-II cut-off score for mortality.
A total of 305 neonates were admitted to NICU over a period of one year. Among them, 255 neonates fulfilled the inclusion criteria. Out of 255 neonates, 45 neonates (17.6%) died and 210 were discharged. SNAPPE-II score was significantly higher among neonates who died compared to those who survived [median (IQR) 57 (42-64) vs. 22 (14-32), P < 0.001]. SNAPPE II score had discrimination to predict mortality with area under ROC Curve (AUC): 0.917 (95% CI, 0.854-0.980). The best cut - off score for predicting mortality was 38 with sensitivity 84.4%, specificity 91%, positive predictive value 66.7% and negative predictive value 96.5%. SNAPPE II score could not predict the duration of NICU stay (P = 0.477).
SNAPPE- II is a useful tool to predict neonatal mortality in NICU. The score of 38 may be associated with higher mortality.
有许多评分系统可用于预测新生儿重症监护病房（NICU）中的新生儿死亡率和发病率。其中一个评分系统是 SNAPPE-II（围产期扩展的新生儿急性生理学评分-II）。本研究旨在评估 SNAPPE-II 评分（围产期扩展的新生儿急性生理学评分-II）作为预测新生儿死亡率和在新生儿重症监护病房（NICU）中停留时间的有效性。
这是一项前瞻性观察研究，于 2015 年 6 月至 2016 年 5 月期间进行。在尼泊尔 BPKIHS 医院的三级保健医院的 NICU 中，符合纳入标准的 255 名新生儿被纳入研究，并计算了 SNAPPE-II 评分。构建受试者工作特征（ROC）曲线以得出死亡率的最佳 SNAPPE-II 截断评分。
在一年的时间里，共有 305 名新生儿入住 NICU。其中，255 名新生儿符合纳入标准。在 255 名新生儿中，有 45 名（17.6%）死亡，210 名出院。死亡的新生儿的 SNAPPE-II 评分明显高于存活的新生儿[中位数（IQR）57（42-64）比 22（14-32），P<0.001]。SNAPPE II 评分具有预测死亡率的区分能力，ROC 曲线下面积（AUC）：0.917（95%CI，0.854-0.980）。预测死亡率的最佳截断分数为 38，灵敏度为 84.4%，特异性为 91%，阳性预测值为 66.7%，阴性预测值为 96.5%。SNAPPE-II 评分不能预测 NICU 停留时间（P=0.477）。
SNAPPE-II 是预测 NICU 新生儿死亡率的有用工具。评分 38 可能与更高的死亡率相关。
