SNAP II and SNAPPE II as Predictors of Neonatal Mortality in a Pediatric Intensive Care Unit : Does Postnatal Age Play a Role?

الملخص EN

Introduction.

In developing countries, a lack of decentralization of perinatal care leads to many high-risk births occurring in facilities that do not have NICU, leading to admission to a PICU.

Objective.

To assess SNAP II and SNAPPE II as predictors of neonatal death in the PICU.

Methodology.

A prospective study of newborns divided into 3 groups according to postnatal age: Group 1 (G1), of 0 to 6 days; Group 2 (G2) of 7 to 14 days; and Group 3 (G3), of 15 to 28 days.

Variables analyzed were SNAP II, SNAPPE II, perinatal data, and known risk factors for death.

The Hosmer-Lemeshow test and the receiver operating characteristics (ROC) curve were used with SPSS 17.0 for statistical analysis.

An Alpha error <5% was considered significant.

Results.

We analyzed 290 newborns, including 192 from G1, 41 from G2, and 57 from G3.

Mortality was similar in all 3 groups.

Median SNAP II was higher in newborns that died in all 3 groups (P<0.05).

The area under the ROC curve for SNAP II for G1 was 0.78 (CI 95% 0.70–0.86), for G2 0.66 (CI 95% 0.37–0.94), and for G3 0.74 (CI 95% 0.53–0.93).

The area under the ROC curve for SNAPPE II for G1 was 0.76 (CI 95% 0.67–0.85), for G2 0.60 (CI 95% 0.30–0.90), and for G3 0.74 (CI 95% 0.52–0.95).

Conclusions.

SNAP II and SNAPPE II showed moderate discrimination in predicting mortality.

The results are not strong enough to establish the correlation between the score and the risk of mortality.