The use of score for neonatal acute physiology perinatal extention II (SNAPPE II) in predicting neonatal outcome in neonatal intensive care unit

  • Mia R A
  • Risa Etika
  • Agus Harianto
  • Fatimah Indarso
  • Sylviati M Damanik
DOI: https://doi.org/10.14238/pi45.6.2005.241-5
Keywords: neonatal mortality, SNAPPE II, NICU

Abstract

Background Scoring systems which quantify initial risks have an
important role in aiding execution of optimum health services by pre-
dicting morbidity and mortality. One of these is the score for neonatal
acute physiology perinatal extention (SNAPPE), developed by
Richardson in 1993 and simplified in 2001. It is derived of 6 variables
from the physical and laboratory observation within the first 12 hours
of admission, and 3 variables of perinatal risks of mortality.
Objectives To assess the validity of SNAPPE II in predicting mor-
tality at neonatal intensive care unit (NICU), Soetomo Hospital,
Surabaya. The study was also undertaken to evolve the best cut-off
score for predicting mortality.
Methods Eighty newborns were admitted during a four-month period
and were evaluated with the investigations as required for the specifi-
cations of SNAPPE II. Neonates admitted >48 hours of age or after
having been discharged, who were moved to lower newborn care <24
hours and those who were discharged on request were excluded. Re-
ceiver operating characteristic curve (ROC) were constructed to derive
the best cut-off score with Kappa and McNemar Test.
Results Twenty eight (35%) neonates died during the study, 22
(82%) of them died within the first six days. The mean SNAPPE II
score was 26.3+19.84 (range 0-81). SNAPPE II score of the
nonsurvivors was significantly higher than the survivors
(42.75+18.59 vs 17.4+14.05; P=0.0001). SNAPPE II had a good
performance in predicting overall mortality and the first-6-days
mortality, with area under the ROC 0.863 and 0.889. The best cut-
off score for predicting mortality was 30 with sensitivity 81.8%,
specificity 76.9%, positive predictive value 60.0% and negative
predictive value 90.0%.
Conclusions SNAPPE II is a measurement of illness severity which
correlates well with neonatal mortality at NICU, Soetomo Hospital.
The score of more than 30 is associated with higher mortality

Author Biographies

Mia R A
Department of Child Health, Medical School, Airlangga
University, Surabaya, Indonesia.
Risa Etika
Department of Child Health, Medical School, Airlangga
University, Surabaya, Indonesia.
Agus Harianto
Department of Child Health, Medical School, Airlangga
University, Surabaya, Indonesia.
Fatimah Indarso
Department of Child Health, Medical School, Airlangga
University, Surabaya, Indonesia.
Sylviati M Damanik
Department of Child Health, Medical School, Airlangga
University, Surabaya, Indonesia.

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Published
2016-10-13
How to Cite
1.
A M, Etika R, Harianto A, Indarso F, Damanik S. The use of score for neonatal acute physiology perinatal extention II (SNAPPE II) in predicting neonatal outcome in neonatal intensive care unit. PI [Internet]. 13Oct.2016 [cited 24Apr.2024];45(6):241-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/880
Issue
Vol 45 No 6 (2005): November 2005
Section
Articles

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Received 2016-10-12
Accepted 2016-10-12
Published 2016-10-13