Venkateshwarlu Vardhelli1, Soutrik Seth2, Yassar Arafat Mohammed3, Srinivas Murki4, Baswaraj Tandur3, Bijan Saha2, Tejo Pratap Oleti4, Saikiran Deshabhotla4, Sunayana Siramshetty5, Venkat Reddy Kallem6. 1. Department of Neonatology, Fernandez Hospital, Unit-2, Opp. Old MLA Quarters, Hyderguda, Hyderabad, Telangana, 500029, India. venkat959@gmail.com. 2. Department of Neonatology, SSKM Hospital, Kolkata, West Bengal, India. 3. Department of Pediatrics, Vijay Marie Hospital, Hyderabad, Telangana, India. 4. Department of Neonatology, Fernandez Hospital, Unit-2, Opp. Old MLA Quarters, Hyderguda, Hyderabad, Telangana, 500029, India. 5. Department of Pediatrics, Princess Durru Shehvar Hospital, Hyderabad, Telangana, India. 6. Department of Neonatology, Paramitha Hospital, Hyderabad, Telangana, India.
Abstract
OBJECTIVE: To compare SNAPPE-II and STOPS admission severity scores in neonates admitted to neonatal intensive care unit (NICU) with a gestational age of ≥ 33 wk. METHODS: In this multicenter, prospective, observational study, the sickness scoring was done on all the neonates at 12 h after admission to the NICUs. The scoring systems were compared by the area under the curve (AUC) on the receiver operating characteristics (ROC) curve. RESULTS: A total of 669 neonates with gestational age ≥ 33 wk (mortality rate: 2.4%), who were admitted to five participating NICUs within 24 h of birth, were included. Both SNAPPE-II and STOPS had the good discriminatory and predictive ability for mortality with AUCs of 0.965 [95% confidence interval (CI): 0.94-0.98] and 0.92 (95% CI: 0.87-0.99), respectively. The STOPS scoring system with a cutoff score ≥ 4 on the ROC curve had 85% accuracy, whereas the SNAPPE-II cutoff score ≥ 33 on the ROC curve had 94% accuracy in predicting mortality. CONCLUSION: In infants with the gestational age of ≥ 33 wk, SNAPPE-II and STOPS showed similar predictive ability, but the STOPS score, being a simpler clinical tool, might be more useful in resource-limited settings.
OBJECTIVE: To compare SNAPPE-II and STOPS admission severity scores in neonates admitted to neonatal intensive care unit (NICU) with a gestational age of ≥ 33 wk. METHODS: In this multicenter, prospective, observational study, the sickness scoring was done on all the neonates at 12 h after admission to the NICUs. The scoring systems were compared by the area under the curve (AUC) on the receiver operating characteristics (ROC) curve. RESULTS: A total of 669 neonates with gestational age ≥ 33 wk (mortality rate: 2.4%), who were admitted to five participating NICUs within 24 h of birth, were included. Both SNAPPE-II and STOPS had the good discriminatory and predictive ability for mortality with AUCs of 0.965 [95% confidence interval (CI): 0.94-0.98] and 0.92 (95% CI: 0.87-0.99), respectively. The STOPS scoring system with a cutoff score ≥ 4 on the ROC curve had 85% accuracy, whereas the SNAPPE-II cutoff score ≥ 33 on the ROC curve had 94% accuracy in predicting mortality. CONCLUSION: In infants with the gestational age of ≥ 33 wk, SNAPPE-II and STOPS showed similar predictive ability, but the STOPS score, being a simpler clinical tool, might be more useful in resource-limited settings.
Authors: K P Mansoor; S R Ravikiran; Vaman Kulkarni; Kiran Baliga; Suchetha Rao; Kamalakshi G Bhat; B Shantharam Baliga; Nutan Kamath Journal: Crit Care Res Pract Date: 2019-05-09