Richardson D K, Gray J E, McCormick M C, Workman K, Goldmann D A
Joint Program in Neonatology, Children's Hospital, Boston, MA 02115.
Pediatrics. 1993 Mar;91(3):617-23.
The substantial variation in birth weight-adjusted mortality among neonatal intensive care units (NICUs) may reflect differences in population illness severity. Development of an illness severity measure is essential for comparisons of outcomes. The Score for Neonatal Acute Physiology (SNAP) was developed and validated prospectively on 1643 admissions (114 deaths) in three NICUs. SNAP scores the worst physiologic derangements in each organ system in the first 24 hours. SNAP showed little correlation with birth weight and was highly predictive of neonatal mortality even within narrow birth weight strata. It was capable of separating patients into groups with 2 to 20 times higher mortality risk. It also correlated highly with other indicators of severity including nursing workload (r = .59), therapeutic intensity (r = .78), physician estimates of mortality risk (r = .65), and length of stay (R2 = .59). SNAP is an important new tool for NICU research.
新生儿重症监护病房（NICU）中出生体重校正死亡率的显著差异可能反映了人群疾病严重程度的不同。制定疾病严重程度衡量标准对于比较治疗结果至关重要。新生儿急性生理学评分（SNAP）是在前瞻性研究中，对三个NICU的1643例入院病例（114例死亡）进行开发和验证的。SNAP对最初24小时内每个器官系统最严重的生理紊乱进行评分。SNAP与出生体重几乎没有相关性，即使在狭窄的出生体重分层内，也能高度预测新生儿死亡率。它能够将患者分为死亡风险高2至20倍的不同组。它还与其他严重程度指标高度相关，包括护理工作量（r = 0.59）、治疗强度（r = 0.78）、医生对死亡风险的估计（r = 0.65）和住院时间（R2 = 0.59）。SNAP是NICU研究的一项重要新工具。
