Severity Index of Neonatal Septicemia in Neonatal Intensive Care units Using Score for Neonatal Acute Physiology-II

Background: This study aimed to evaluate the competence of the score for neonatal acute physiology (SNAP-II) as a tool to anticipate morbidity and mortality of neonates with early or late sepsis in neonatal intensive care units (NICUs). Methods: This prospective cohort study was conducted on all neonates of > ۳۲ weeks with sepsis in tertiary NICUs at Cairo University Children Hospital and El Galaa Hospital For Armed Forces Officers Families, Cairo, Egypt, within May-October ۲۰۱۹. The eligible samples consisted of ۱۰۰ neonates with septicemia who met inclusion and exclusion criteria and were enrolled. the score for neonatal acute physiology-II was calculated within ۲۴ h of sepsis onset and followed up for ۲ weeks for mortality and organ dysfunction (OD). The collected data were analyzed in SPSS software (version ۲۵). Results: It was revealed thatSNAP-II was significantly higher in neonates who passed away, compared to the survived neonates (۴۶±۱۷ vs. ۱۲±۱۰, respectively; P<۰.۰۰۱). Moreover, SNAP-II was significantly higher in neonates who developed OD within ۱۴ days of sepsis onset, compared to those without OD (۳۷±۱۷ vs. ۹±۷, respectively; P<۰.۰۰۱). The score for neonatal acute physiology-II at ۱۴.۵ was considered the best cut-off point in predicting OD with a sensitivity of ۱۰۰%, positive predictive value of ۷۰.۴%, specificity of ۸۱.۲%, and negative predictive value of ۱۰۰%. In addition, SNAP-II at ۲۳.۵ was considered the best cut-off point in predicting overall mortality with ۱۰۰% sensitivity, ۵۸.۶% PPV, ۸۵.۵% specificity, and ۱۰۰% NPV. Conclusion: Higher SNAP-II within ۲۴ h of the early- or late-onset neonatal sepsis was a reliable predictor of OD and death.    

کلیدواژه ها:

Mortality ، Neonates ، organ dysfunction ، Sepsis ، SNAP-II