Determination of predictive power of CRIB-II and SNAPPE-II in mortality risk of low gestational age or birth weight neonates admitted to NICU

Document Type: Original Article

Authors

1 Maternal,Fetal & Neonatal Research Center-TUMS

2 Institute of Family Health, Breastfeeding Research Center, Tehran University of Medical Sciences, Tehran, Iran

3 Institute of Family Health, Maternal, Fetal and Neonatal Health Research Center, Tehran University of Medical Sciences, Tehran, Iran

4 1. Maternal, Fetal and Neonatal Research Center, Tehran University of medical sciences, Tehran, Iran. 2. Breastfeeding research center, Tehran University of medical sciences, Tehran, Iran.

5 Neonatal Health Office, Ministry of Health, Management and Education of Iran, Tehran, Iran

6 MSc student in Nursing, Department of Pediatric & Neonatal Intensive Care Nursing, Nursing & Midwifery School, ShahidBeheshti University of

7 MSc in Nursing, Department of Pediatric & Neonatal Intensive Care Nursing, Nursing & Midwifery School, ShahidBeheshti University of Medical Sciences, Tehran, Iran

Abstract

Background: Risk scoring systems evaluate neonatal outcomes using perinatal and neonatal status. The present study aimed to predict the mortality risk of preterm or low birth weight infants using the Clinical Risk Index for Babies (CRIB-II) and Score for Neonatal Acute Physiology Perinatal Extension (SNAPPE-II) scoring systems.
Methods: In this prospective cohort study, preterm infants admitted to the neonatal intensive care unit (NICU) of Vali-e-Asr Hospital of Tehran with birth weight of ˂1500g or gestational age ˂32-weeks were investigated by the CRIB-II and SNAPPE-II scoring systems within the first 12 hours after birth. Area under the Curve (AUC) Sensitivity, specificity, positive and negative predictive values of the scoring systems also the association of neonate factors and neonatal death was calculated.
Results: 253 neonates from 344 studied infants survived after 24-hour of birth and 91 died. The total CRIB-II score in surviving and died infants were 6.12 and 10.28 respectively. The area under the ROC curve with cut-off point of 8.5 was 0.838. Sensitivity 74.4%, specificity 78.65%, positive predictive value 55.37% and negative predictive value 89.68% were calculated for the CRIB-II system. Total scores of SNAPPE-II in surviving and dead infants were 16.9 and 51.6 respectively. The area under the ROC curve with cut-off point of 27.5 was 0.887. Sensitivity 84.44% and specificity 79.05% were calculated for the SNAPPE-II; also, positive and negative predictive values were 58.91% and 93.46% respectively.
Conclusion: Our study demonstrated that the CRIB-II and SNAPPE-II scoring systems can be useful mortality predictors in at-risk neonates.

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