Determination of the strength of SNAPPE II score (Score for Neonatal Acute Physiology with Perinatal Extension-II) to predict neonatal mortality in a neonatal intensive care unit of tertiary care hospital: A prospective observational study

Abstract

Aim: The Score for Neonatal Acute Physiology with Perinatal Extension-II (SNAPPE-II) is a novel risk prediction system for neonatal mortality. This observational study aims to determine its ability to predict mortality risk in neonates admitted to the neonatal intensive care unit (NICU). Methodology: This prospective observational research was conducted for 12 months, from October 2021 to September 2022. Seventy-eight newborns, who fulfilled the inclusion criteria, were enrolled in our study. The outcomes of neonates were compared with the degree of SNAPPE II score calculated for respective neonates after admission. A receiver operating characteristic (ROC) curve was generated to determine the optimum SNAPPE-II cutoff score for mortality. Results: During the period of research, 292 newborns got admitted to our NICU. Among these, 78 neonates met the requirements for inclusion. Thirty-two infants (39.71%) of the 78 neonates died, while 47 were discharged. Newborns who died had substantially higher SNAPPE-II scores than those who lived (median [interquartile range] 37 [5–67] vs. 13 [0–48], P = 0.001). The area under the ROC curve (area under the curve): 0.837 (95% confidence interval, 0.73–0.91); SNAPPE II score demonstrated the ability to predict mortality. The cutoff score with the highest sensitivity and specificity for predicting death was 29. Compared to newborns with a SNAPPE II score of 29 or less, those over 29 had a considerably increased chance of mortality. The odds ratio estimate was 15.27, which indicates that neonates with high scores have around 15 times the risk of dying, as do those with low scores. Conclusion: This study suggests that the SNAPPE II score is a valuable tool for predicting mortality in neonates admitted to the NICU.