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Predicting mortality in infants with persistent pulmonary hypertension of the newborn with the Score for Neonatal Acute Physiology-Version II (SNAP-II) in Thai neonates
-
Narongsak Nakwan
,
Narongwit Nakwan
Published/Copyright:
April 14, 2011
Abstract
Aim: To evaluate the ability of the Score for Neonatal Acute Physiology-Version II (SNAP-II) to predict mortality in infants with persistent pulmonary hypertension of the newborn (PPHN).
Methods: A prospective cohort study of 41 infants with PPHN admitted to our neonatal intensive care unit between June 2008 and March 2010, who underwent a SNAP-II test within 12 h of admission.
Results: Of the 41 infants, 14 died (34.1%) and 27 survived (65.9%). The SNAP-II scores were significantly higher in infants who died (50.1±18.5 vs. 35.7±16.8, P=0.02). Each point increase in the SNAP score increased the odds of mortality by 1.04 [95% confidence interval (CI) 1.01–1.07, P<0.01]. Infants who had a SNAP-II score of ≥43 had the greatest mortality risk with an odds ratio (OR) of 10.00 (95% CI 1.03–97.50). The SNAP-II model showed moderate discrimination in predicting mortality with a result of 0.72 (95% CI 0.56–0.88) under the receiver operating characteristic curve. The lowest blood pressure, lowest PaO2/FIO2 ratio, and urine output within the first 12 h of admission were also independently found to be good predictors of an increased risk for death.
Conclusion: The SNAP-II scoring system significantly predicted mortality. PPHN infants with a SNAP-II score of ≥43 had the greatest mortality risk.
Keywords: Neonatal mortality; persistent pulmonary hypertension of the newborn; predictive value of tests; Score for Neonatal Acute Physiology-Version II; severity of illness index
Received: 2010-8-25
Revised: 2010-10-6
Accepted: 2010-10-21
Published Online: 2011-04-14
Published Online: 2011-04-14
Published in Print: 2011-05-01
©2011 by Walter de Gruyter Berlin New York
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