SNAPPE II: ANALYSIS OF ACCURACY AND DETERMINATION OF THE CUTOFF POINT AS A DEATH PREDICTOR IN A BRAZILIAN NEONATAL INTENSIVE CARE UNIT

Detalhes bibliográficos
Autor(a) principal: Fontenele,Maria Marcia Farias Trajano
Data de Publicação: 2020
Outros Autores: Silva,Cristiana Ferreira, Leite,Álvaro Jorge Madeiro, Castro,Eveline Campos Monteiro, Carvalho,Francisco Herlânio Costa, Silva,Ana Valeska Siebra e
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Revista Paulista de Pediatria (Ed. Português. Online)
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0103-05822020000100454
Resumo: ABSTRACT Objective: To analyze the accuracy of the Score for Neonatal Acute Physiology Perinatal Extension (SNAPPE II) as a death predictor, to determine the cutoff point for mortality, and to analyze the association of independent variables with death. Methods: Prospective, longitudinal, hospital-based study on newborns admitted to the Neonatal Intensive Care Unit (NICU) for the first time from November 1, 2016 to April 30, 2017. Newborns with less than 12 hours of length of stay at the NICU, out-of-hospital births, major congenital malformations, and inter-hospital transfer were excluded. Variables were grouped according to hierarchical framework, related to maternal characteristics (distal level), prenatal and childbirth care (intermediate level), and birth conditions (proximal level). Descriptive analyses of SNAPPE II score ranges, Receiver Operating Characteristics Curve (ROC curve) to define the cutoff point for mortality, and bivariate analysis by the Wald test and multiple logistic regression were conducted. Results: After selection, the sample consisted of 247 newborns. In this study, the SNAPPE II cutoff point for mortality was 27, with sensitivity of 84.1% and specificity of 82.4%. 61% of those with a score ≥27 died. Multiple logistic regression showed an association between death and proximal-level variables: sepsis (Odds Ratio [OR] 10.68; 95% confidence interval [95%CI] 2.82–40.48; p<0.001); SNAPPE II ≥27 (OR 5.85; 95%CI 1.90–18.05; p=0.002); birth weight 750–999 g (OR 4.15; 95%CI 1.06–16.14; p=0.040); and nonuse of surfactant (OR 0.159; 95%CI 0.04–0.53; p=0.003). Conclusions: Neonatal mortality was directly proportional to increase in SNAPPE II. Score≥27 increased the odds of dying by six times compared with neonates with lower scores. The proximal variables related to health conditions and neonatal care were associated with death.
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spelling SNAPPE II: ANALYSIS OF ACCURACY AND DETERMINATION OF THE CUTOFF POINT AS A DEATH PREDICTOR IN A BRAZILIAN NEONATAL INTENSIVE CARE UNITInfant mortalityNeonatal mortalitySeverity of illness indexABSTRACT Objective: To analyze the accuracy of the Score for Neonatal Acute Physiology Perinatal Extension (SNAPPE II) as a death predictor, to determine the cutoff point for mortality, and to analyze the association of independent variables with death. Methods: Prospective, longitudinal, hospital-based study on newborns admitted to the Neonatal Intensive Care Unit (NICU) for the first time from November 1, 2016 to April 30, 2017. Newborns with less than 12 hours of length of stay at the NICU, out-of-hospital births, major congenital malformations, and inter-hospital transfer were excluded. Variables were grouped according to hierarchical framework, related to maternal characteristics (distal level), prenatal and childbirth care (intermediate level), and birth conditions (proximal level). Descriptive analyses of SNAPPE II score ranges, Receiver Operating Characteristics Curve (ROC curve) to define the cutoff point for mortality, and bivariate analysis by the Wald test and multiple logistic regression were conducted. Results: After selection, the sample consisted of 247 newborns. In this study, the SNAPPE II cutoff point for mortality was 27, with sensitivity of 84.1% and specificity of 82.4%. 61% of those with a score ≥27 died. Multiple logistic regression showed an association between death and proximal-level variables: sepsis (Odds Ratio [OR] 10.68; 95% confidence interval [95%CI] 2.82–40.48; p<0.001); SNAPPE II ≥27 (OR 5.85; 95%CI 1.90–18.05; p=0.002); birth weight 750–999 g (OR 4.15; 95%CI 1.06–16.14; p=0.040); and nonuse of surfactant (OR 0.159; 95%CI 0.04–0.53; p=0.003). Conclusions: Neonatal mortality was directly proportional to increase in SNAPPE II. Score≥27 increased the odds of dying by six times compared with neonates with lower scores. The proximal variables related to health conditions and neonatal care were associated with death.Sociedade de Pediatria de São Paulo2020-01-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0103-05822020000100454Revista Paulista de Pediatria v.38 2020reponame:Revista Paulista de Pediatria (Ed. Português. Online)instname:Sociedade de Pediatria de São Paulo (SPSP)instacron:SPSP10.1590/1984-0462/2020/38/2019029info:eu-repo/semantics/openAccessFontenele,Maria Marcia Farias TrajanoSilva,Cristiana FerreiraLeite,Álvaro Jorge MadeiroCastro,Eveline Campos MonteiroCarvalho,Francisco Herlânio CostaSilva,Ana Valeska Siebra eeng2020-12-14T00:00:00Zoai:scielo:S0103-05822020000100454Revistahttps://www.rpped.com.br/ONGhttps://old.scielo.br/oai/scielo-oai.phppediatria@spsp.org.br||rpp@spsp.org.br1984-04620103-0582opendoar:2020-12-14T00:00Revista Paulista de Pediatria (Ed. Português. Online) - Sociedade de Pediatria de São Paulo (SPSP)false
dc.title.none.fl_str_mv SNAPPE II: ANALYSIS OF ACCURACY AND DETERMINATION OF THE CUTOFF POINT AS A DEATH PREDICTOR IN A BRAZILIAN NEONATAL INTENSIVE CARE UNIT
title SNAPPE II: ANALYSIS OF ACCURACY AND DETERMINATION OF THE CUTOFF POINT AS A DEATH PREDICTOR IN A BRAZILIAN NEONATAL INTENSIVE CARE UNIT
spellingShingle SNAPPE II: ANALYSIS OF ACCURACY AND DETERMINATION OF THE CUTOFF POINT AS A DEATH PREDICTOR IN A BRAZILIAN NEONATAL INTENSIVE CARE UNIT
Fontenele,Maria Marcia Farias Trajano
Infant mortality
Neonatal mortality
Severity of illness index
title_short SNAPPE II: ANALYSIS OF ACCURACY AND DETERMINATION OF THE CUTOFF POINT AS A DEATH PREDICTOR IN A BRAZILIAN NEONATAL INTENSIVE CARE UNIT
title_full SNAPPE II: ANALYSIS OF ACCURACY AND DETERMINATION OF THE CUTOFF POINT AS A DEATH PREDICTOR IN A BRAZILIAN NEONATAL INTENSIVE CARE UNIT
title_fullStr SNAPPE II: ANALYSIS OF ACCURACY AND DETERMINATION OF THE CUTOFF POINT AS A DEATH PREDICTOR IN A BRAZILIAN NEONATAL INTENSIVE CARE UNIT
title_full_unstemmed SNAPPE II: ANALYSIS OF ACCURACY AND DETERMINATION OF THE CUTOFF POINT AS A DEATH PREDICTOR IN A BRAZILIAN NEONATAL INTENSIVE CARE UNIT
title_sort SNAPPE II: ANALYSIS OF ACCURACY AND DETERMINATION OF THE CUTOFF POINT AS A DEATH PREDICTOR IN A BRAZILIAN NEONATAL INTENSIVE CARE UNIT
author Fontenele,Maria Marcia Farias Trajano
author_facet Fontenele,Maria Marcia Farias Trajano
Silva,Cristiana Ferreira
Leite,Álvaro Jorge Madeiro
Castro,Eveline Campos Monteiro
Carvalho,Francisco Herlânio Costa
Silva,Ana Valeska Siebra e
author_role author
author2 Silva,Cristiana Ferreira
Leite,Álvaro Jorge Madeiro
Castro,Eveline Campos Monteiro
Carvalho,Francisco Herlânio Costa
Silva,Ana Valeska Siebra e
author2_role author
author
author
author
author
dc.contributor.author.fl_str_mv Fontenele,Maria Marcia Farias Trajano
Silva,Cristiana Ferreira
Leite,Álvaro Jorge Madeiro
Castro,Eveline Campos Monteiro
Carvalho,Francisco Herlânio Costa
Silva,Ana Valeska Siebra e
dc.subject.por.fl_str_mv Infant mortality
Neonatal mortality
Severity of illness index
topic Infant mortality
Neonatal mortality
Severity of illness index
description ABSTRACT Objective: To analyze the accuracy of the Score for Neonatal Acute Physiology Perinatal Extension (SNAPPE II) as a death predictor, to determine the cutoff point for mortality, and to analyze the association of independent variables with death. Methods: Prospective, longitudinal, hospital-based study on newborns admitted to the Neonatal Intensive Care Unit (NICU) for the first time from November 1, 2016 to April 30, 2017. Newborns with less than 12 hours of length of stay at the NICU, out-of-hospital births, major congenital malformations, and inter-hospital transfer were excluded. Variables were grouped according to hierarchical framework, related to maternal characteristics (distal level), prenatal and childbirth care (intermediate level), and birth conditions (proximal level). Descriptive analyses of SNAPPE II score ranges, Receiver Operating Characteristics Curve (ROC curve) to define the cutoff point for mortality, and bivariate analysis by the Wald test and multiple logistic regression were conducted. Results: After selection, the sample consisted of 247 newborns. In this study, the SNAPPE II cutoff point for mortality was 27, with sensitivity of 84.1% and specificity of 82.4%. 61% of those with a score ≥27 died. Multiple logistic regression showed an association between death and proximal-level variables: sepsis (Odds Ratio [OR] 10.68; 95% confidence interval [95%CI] 2.82–40.48; p<0.001); SNAPPE II ≥27 (OR 5.85; 95%CI 1.90–18.05; p=0.002); birth weight 750–999 g (OR 4.15; 95%CI 1.06–16.14; p=0.040); and nonuse of surfactant (OR 0.159; 95%CI 0.04–0.53; p=0.003). Conclusions: Neonatal mortality was directly proportional to increase in SNAPPE II. Score≥27 increased the odds of dying by six times compared with neonates with lower scores. The proximal variables related to health conditions and neonatal care were associated with death.
publishDate 2020
dc.date.none.fl_str_mv 2020-01-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
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dc.identifier.uri.fl_str_mv http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0103-05822020000100454
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0103-05822020000100454
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 10.1590/1984-0462/2020/38/2019029
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv text/html
dc.publisher.none.fl_str_mv Sociedade de Pediatria de São Paulo
publisher.none.fl_str_mv Sociedade de Pediatria de São Paulo
dc.source.none.fl_str_mv Revista Paulista de Pediatria v.38 2020
reponame:Revista Paulista de Pediatria (Ed. Português. Online)
instname:Sociedade de Pediatria de São Paulo (SPSP)
instacron:SPSP
instname_str Sociedade de Pediatria de São Paulo (SPSP)
instacron_str SPSP
institution SPSP
reponame_str Revista Paulista de Pediatria (Ed. Português. Online)
collection Revista Paulista de Pediatria (Ed. Português. Online)
repository.name.fl_str_mv Revista Paulista de Pediatria (Ed. Português. Online) - Sociedade de Pediatria de São Paulo (SPSP)
repository.mail.fl_str_mv pediatria@spsp.org.br||rpp@spsp.org.br
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