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Change in Score for Neonatal Acute Physiology-II Measurements for Prediction of Mortality in Severely Septic Preterm Neonates

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Indian Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Objective

To study the discriminatory ability of the change (delta) in the Score for Neonatal Acute Physiology-II (SNAP-II) for 14-d mortality in preterm neonates with severe sepsis.

Methods

Consecutively born neonates of < 34-wk gestation during the 1-y study period in a tertiary care neonatal unit were included. SNAP-II was recorded at the onset of severe sepsis (T0) and serially at 24 (T1), 48 (T2), and 72 (T3) h. Delta scores (Δ SNAP-II) were derived from the difference between the SNAP-II at baseline and each one of the subsequent time points.

Results

Seventy-one preterm neonates were enrolled. Baseline characteristics were similar in survivors (n = 53) and nonsurvivors (n = 18). Median SNAP-II at all the four time points were significantly higher in nonsurvivors (p < 0.001). Delta SNAP-II (T0–T2) was significantly different between nonsurvivors and survivors (mean difference: −14.7; 95% CI: −29, −0.9; p = 0.02), while the difference was not significant between T0–T1 and T0–T3. Initial SNAP-II had a significantly better discriminating ability than Δ SNAP-II at various time points (AUC, 95% CI: 0.59, 0.41–0.75 for T0–T1; 0.70, 0.50–0.87 for T0–T2; and 0.64; 0.38–0.89 for T0–T3).

Conclusions

Delta SNAP-II does not have a better discriminatory ability for mortality by 14 d in preterm neonates with severe sepsis.

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Data Availability

The deidentified patient data will be shared upon a reasonable request.

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Authors and Affiliations

  1. Department of Pediatrics, All India Institute of Medical Sciences, Bibinagar, Hyderabad, Telangana, India

    Rajendra Prasad Anne

  2. Division of Neonatology, Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India

    Venkataseshan Sundaram & Praveen Kumar

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  1. Rajendra Prasad Anne
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  2. Venkataseshan Sundaram
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  3. Praveen Kumar
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Contributions

RPA and VS conceptualized the study, collected the data, did the analysis, and prepared the manuscript; PK provided critical inputs to the study design, assisted in analysis, and critically edited the manuscript; All the authors approved the final version of the manuscript. VS will act as the guarantor for this paper.

Corresponding author

Correspondence to Venkataseshan Sundaram.

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Ethics Approval

The study protocol was approved by the Institute Ethics Committee, PGIMER, Chandigarh, India.

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Informed written consent was obtained from one of the parents in all the enrolled subjects prior to enrollment.

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Anne, R.P., Sundaram, V. & Kumar, P. Change in Score for Neonatal Acute Physiology-II Measurements for Prediction of Mortality in Severely Septic Preterm Neonates. Indian J Pediatr 90, 348–354 (2023). https://doi.org/10.1007/s12098-022-04190-4

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  • DOI: https://doi.org/10.1007/s12098-022-04190-4

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