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Journal of Perinatal Medicine

Official Journal of the World Association of Perinatal Medicine

Editor-in-Chief: Dudenhausen, Joachim W.

Editorial Board Member: / Bancalari, Eduardo / Greenough, Anne / Genc, Mehmet R. / Chervenak, Frank A. / Chappelle, Joseph / Bergmann, Renate L. / Bernardes, J.F. / Bevilacqua, G. / Blickstein, Isaac / Cabero Roura, Luis / Carbonell-Estrany, Xavier / Carrera, Jose M. / D`Addario, Vincenzo / D'Alton, MD, Mary E. / Dimitrou, G. / Grunebaum, Amos / Hentschel, Roland / Köpcke, W. / Kawabata, Ichiro / Keirse, Marc J.N.C. / Kurjak M.D., Asim / Lee, Ben H. / Levene, Malcolm / Lockwood, Charles J. / Marsal, Karel / Makatsariya, Alexander / Nishida, Hiroshi / Ogata, Edward / Papp, Zoltán / Pejaver, Ranjan Kumar / Pooh, Ritsuko K. / Romero, Roberto / Saugstad, Ola D. / Schenker, Joseph G. / Sen, Cihat / Seri, Istvan / Vetter, Klaus / Winn, Hung N. / Young, Bruce K. / Zimmermann, Roland


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1619-3997
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Predicting mortality in infants with persistent pulmonary hypertension of the newborn with the Score for Neonatal Acute Physiology-Version II (SNAP-II) in Thai neonates

1, 2 / Narongwit Nakwan3 / Jeerawan Wannaro2

1Neonatal Intensive Care Unit, Hat Yai Medical Education Center, Hat Yai Hospital, Songkhla, Thailand

2Department of Pediatrics, Hat Yai Medical Education Center, Hat Yai Hospital, Songkhla, Thailand

3Department of Medicine, Hat Yai Medical Education Center, Hat Yai Hospital, Songkhla, Thailand

Corresponding author: Narongsak Nakwan, MD Neonatal Intensive Care Unit Department of Pediatrics Hat Yai Medical Education Center Hat Yai Hospital Songkhla 90110 Thailand Tel.: +66 81 8980546 Fax: +66 74 273161

Citation Information: Journal of Perinatal Medicine. Volume 39, Issue 3, Pages 311–315, ISSN (Online) 1619-3997, ISSN (Print) 0300-5577, DOI: 10.1515/jpm.2011.011, April 2011

Publication History

Received:
2010-08-25
Revised:
2010-10-06
Accepted:
2010-10-21
Published Online:
2011-04-14

Abstract

Aim: To evaluate the ability of the Score for Neonatal Acute Physiology-Version II (SNAP-II) to predict mortality in infants with persistent pulmonary hypertension of the newborn (PPHN).

Methods: A prospective cohort study of 41 infants with PPHN admitted to our neonatal intensive care unit between June 2008 and March 2010, who underwent a SNAP-II test within 12 h of admission.

Results: Of the 41 infants, 14 died (34.1%) and 27 survived (65.9%). The SNAP-II scores were significantly higher in infants who died (50.1±18.5 vs. 35.7±16.8, P=0.02). Each point increase in the SNAP score increased the odds of mortality by 1.04 [95% confidence interval (CI) 1.01–1.07, P<0.01]. Infants who had a SNAP-II score of ≥43 had the greatest mortality risk with an odds ratio (OR) of 10.00 (95% CI 1.03–97.50). The SNAP-II model showed moderate discrimination in predicting mortality with a result of 0.72 (95% CI 0.56–0.88) under the receiver operating characteristic curve. The lowest blood pressure, lowest PaO2/FIO2 ratio, and urine output within the first 12 h of admission were also independently found to be good predictors of an increased risk for death.

Conclusion: The SNAP-II scoring system significantly predicted mortality. PPHN infants with a SNAP-II score of ≥43 had the greatest mortality risk.

Keywords: Neonatal mortality; persistent pulmonary hypertension of the newborn; predictive value of tests; Score for Neonatal Acute Physiology-Version II; severity of illness index

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[2]
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[3]
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[4]
Jill G. Zwicker, Ruth E. Grunau, Elysia Adams, Vann Chau, Rollin Brant, Kenneth J. Poskitt, Anne Synnes, and Steven P. Miller
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