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[Predictive value of SNAP and SNAP-PE for neonatal mortality]
R de C Silveira1, M Schlabendorff, R S Procianoy
1Hospital de Clínicas de Porto Alegre, RS, Brazil.
Jornal De Pediatria
|December 4, 2003
Summary
The Score for Neonatal Acute Physiology (SNAP) and its perinatal extension (SNAP-PE) effectively predict neonatal mortality. These scores are recommended for use in neonatal intensive care units to assess infant survival risk.
Area of Science:
- Neonatal intensive care
- Clinical prediction models
- Perinatal health
Background:
- Neonatal mortality remains a significant concern in intensive care settings.
- Accurate prediction of mortality risk is crucial for resource allocation and patient management.
- The Score for Neonatal Acute Physiology (SNAP) and its perinatal extension (SNAP-PE) are established scoring systems.
Purpose of the Study:
- To evaluate the predictive accuracy of SNAP and SNAP-PE for neonatal mortality.
- To compare the performance of SNAP and SNAP-PE in a neonatal intensive care unit (NICU) population.
- To determine optimal cutoff points for these scores.
Main Methods:
- Prospective evaluation of 553 newborn infants admitted to the NICU over 21 months.
- SNAP and SNAP-PE scores were calculated at 24 hours of life.
- Exclusion criteria included early death/discharge, lethal congenital malformations, and outborn infants.
Main Results:
- Higher SNAP and SNAP-PE scores correlated with increased mortality rates.
- Optimal cutoff points were identified: SNAP ≥ 12 and SNAP-PE ≥ 24.
- Area under the ROC curve (Az) indicated strong predictive power: SNAP (81.4%) and SNAP-PE (85.1%).
Conclusions:
- Both SNAP and SNAP-PE demonstrate excellent predictive capability for neonatal survival.
- The study recommends the routine implementation of SNAP and SNAP-PE in NICUs.
- These scores can aid in risk stratification and clinical decision-making for neonates.