Assessment of the SNAP-II Score and other Factors for Predicting the Fate of Admitted Neonates to the Neonatal Intensive Care Unit (NICU) of Imam Reza Hospital in Kermanshah

Background and Objective: The survival rate of newborns not only depends on birth weight and gestational age, but also on other factors including physiological conditions and especially disease severity during the first hours of life. This study was designed to assess different variables and particularly the score for Neonatal Acute Physiology-II (SNAP-II), and their impact on the fate of the admitted neonates at the neonatal intensive care unit of Imam Reza Hospital in Kermanshah province of Iran. Materials and Methods: This descriptive analytical study was conducted on all newborns admitted to the Imam Reza Hospital NICU between October ۲۰۰۹ and March ۲۰۱۰. Demographic data, APGAR scores at minutes ۱ and ۵, referral center, previous hospitalization history, and the initial and final diagnosis were evaluated and recorded for each neonate. The SNAP-II scores, based on collected data within the first ۱۲ hours of admission, were also calculated. All neonates were followed up until discharge or death. Data were analyzed by chi-square and independent t-test. Results: A total of ۲۸۷ newborns were entered into the study. The neonatal mortality rate was ۱۳.۶% (۳۹ neonates). There were significant correlations between the mortality rate and birth weight (P<۰.۰۰۰۱), gestational age (P<۰.۰۰۳), APGAR scores in minutes ۱ and ۵, and SNAP-II score higher than ۴۰ (P<۰.۰۰۰۱). There were no statistically significant differences found between the mortality rate, sex, referral center, and previous hospitalization history. Conclusion: It seems that an SNAP-II score of more than ۴۰ and the mean birth weight have the highest diagnostic value in predicting the mortality rate for the neonates. The APGAR scores in the first and fifth minutes of birth, and also the gestational age could be used as additional useful predictors for the mortality rate in neonates.

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Keywords: Neonate ، SNAP-II ، Mortality rate