Abstract
Background
Respiratory failure is a most serious neonatal disorder. A severity of illness assessment should be performed for mechanically ventilated infants to predict the probability of hospital mortality and to assist clinical decision making.
Objectives
To evaluate the ability of the Score for Neonatal Acute Physiology, version II (SNAP-II) to predict the mortality risk for the infants who are mechanically ventilated with positive pressure ventilation (PPV) at a neonatal intensive care unit (NICU).
Methods
A prospective observational cohort study was performed in a 12-bed level III NICU at Hat Yai Hospital between January 2010 and December 2010.
Results
During the study period, 46 infants were ventilated with PPV at admission. Of these, 8 died (17%) and 30 survived (83%). The overall mean SNAP-II score was significantly higher in the group of infants who died compared with those who survived (36.5 ± 11.5 vs. 22.3 ± 13.6, P < 0.01, respectively).The area under the receiver operating characteristic curve for the SNAP-II was 0.79 (95% confidence interval (CI) 0.66 to 0.92, P = 0.01). Every one-point increment of SNAP-II was associated with an odds ratio of 1.08 (95% CI 1.02 to 1.14, P < 0.01). The stratification of the two sets of scores when compared between groups showed that infants who had SNAP-II scores of ≥32 had the highest mortality risk with an odds ratio of 9.7 (95% CI 1.7 to 56.5) with sensitivity of 75.0% and specificity of 76.3%.
Conclusion
SNAP-II scores can significantly predict mortality in infants requiring mechanical PPV.