Neonatal mortality risk assessment in a neonatal intensive care unit (NICU) (original) (raw)
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International Journal of General Medicine
Background: Early neonatal death is death of infants in the first week of life. And 34% to 92% of neonatal deaths happen within 7 days of postnatal period. Thus, the early neonatal period is the most critical time for an infant, requiring different strategies to prevent mortality. Among strategies, deriving and implementing early warning scores is crucial to predict early neonatal mortality earlier upon hospital admission. Objective: To derive and validate a risk score to predict mortality of early neonates at Felege Hiwot Specialized Hospital neonatal intensive care unit, Bahir Dar, 2021. Methods: The document review was conducted from February 24, to April 08, 2021, on all early neonates admitted to neonatal intensive care unit from January 1, 2018 to December 31, 2020. The total number of early neonates included in the derivation study was 1100. Data were collected by using checklists prepared on EpiCollect5 software. After exporting the data to R version 4.0.5 software, variables with (p < 0.25) from the simple binary regression were entered into a multiple logistic regression model, and significant variables (p < 0.05) were kept in the model. The discrimination and calibration were assessed. The model was internally validated using bootstrapping technique. Results: Admission weight, birth Apgar score, perinatal asphyxia, respiratory distress syndrome, mode of delivery, sepsis, and gestational age at birth remained in the final multiple logistic regression prediction model. The area under curve of receiver operating characteristic curve for early neonatal mortality score was 90.7%. The model retained excellent discrimination under internal validation. The sensitivity, specificity, and positive predictive value, negative predictive value of the model was 89.4%, 82.5%, 55.5%, and 96.9%, respectively. Conclusion: The derived score has an excellent discriminative ability and good prediction performance. This is an important tool for predicting early neonatal mortality in neonatal intensive care units at admission.
Paediatrica Indonesiana, 2009
Background The assesment of severity of illness with scoringsystem has been used to predict neonatal mortality in neonatalintensive care unit (NICU). Score for Neonatal Acute PhysiologyPerinatal Extension II (SNAPPE II) is the best scoring systemalthough most of the studies were commonly conducted indeveloped countries.Objective To evaluate SNAPPE II as the predictor of neonatalmortality in NICU Hasan Sadikin General Hospital (HSGH)Ban dung.Methods This was a longitudinal observational study. All neonateshospitalized in NICU HSGH during the period of August toNovember 2008 were investigated according to SNAPPE IIrequirements. We excluded subjects admitted more than 48hours of age, who were discharged or moved to intermediatenewborn care ward less than 24 hours after admission. Predictionof mortality and determination of SNAPPE II cut-off point wereanalyzed using logistic regression. Discrimination was analyzedusing receiver operating characteristic (ROC) and calibration wasanalyzed ...
International Journal of Contemporary Pediatrics
Background: The measurement of severity of illness using scoring systems is an important aspect in predicting mortality and morbidity in intensive care units which in turn can help in optimizing the limited healthcare resources in developing countries. The primary objective was to determine the correlation between clinical risk index of babies-II (CRIB-II) and score for neonatal acute physiology-II (SNAP-II) scores while the secondary objective was to identify which among them is superior in predicting mortality and morbidity in preterm neonates.Methods: The components of CRIB-II and SNAP-II scores were recorded prospectively over a period of 1 year in preterm very low birth weight (VLBW) babies and receiver-operating-characteristics (ROCs) were plotted for comparison. Correlation between CRIB-II and SNAP-II was examined by Pearson technique. The ability of CRIB-II and SNAP-II scores to correctly predict mortality, was assessed by calculating ROCs and their associated area under the...
Iranian Journal of Neonatology IJN, 2020
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: This prospective cohort study investigated the preterm neonates admitted to the Neonatal Intensive Care Unit (NICU) of Vali-e-Asr Hospital, Tehran, Iran, with the birth weight of ˂1500g or a gestational age˂32weeks using the CRIB-II and SNAPPE-II scoring systems within the first 12 h after birth. The area under the curve, sensitivity, specificity, positive and negative predictive values of the scoring systems, as well as the association between neonate factors and neonatal death were calculated in this study.Results: Out of 344 neonates under study, 253casessurvived after24hof birth and 91 newborns died. The total CRIB-II scores in survived and deceas...
Archives of Medicine and Health Sciences, 2020
Background and Aim: Very low birth weight (VLBW) neonates constitute approximately 4%–7% of all live births and their mortality is very high (50%). There has been an effort in recent times to develop the severity score for the illness like score for neonatal acute physiology perinatal extension II (SNAPPE‑II) score so that it is possible to prevent, particularly aiming the improvement of newborn children care. The study aimed to determine the validity of SNAPPE‑II in predicting the VLBW neonates’ mortality risk in the neonatal intensive care unit (NICU) at teaching hospital of Raipur, Chhattisgarh. Materials and Methods: This was a hospital‑based prospective study carried out among all premature newborns weighing <1500 g and more than 26 weeks admitted to the NICU with a sample size of 129. The variables of SNAPPE‑II score were prospectively recorded within 12 h of admission, and their outcome was monitored till 28 days postbirth period. All tests were performed at a 5% level of significance. Results: The SNAPPE II score of the dead neonates was significantly higher than the surviving neonates (43.6 ± 17.25 vs. 18.2 ± 13.09; P < 0.001), and the receiver operating characteristics (ROC) showed that discriminating ability of SNAPPE‑II score was 0.857 (good). The best cutoff for SNAPPE II score in predicting neonatal mortality on charting the ROC was 31. Conclusion: The present study was conducted to specifically design to evaluate the validity of SNAPPE II score as predictor of neonatal mortality in VLBW infants and helps in prioritizing them so we can intervene and prevent mortality in these neonates.
2020
Background: The scoring systems evaluate neonatal outcomes based on perinatal factors in the Neonatal Intense Course Unit (NICU). Aim: This study aimed to predict mortality risk in preterm neonates for the first time, using the Clinical Risk Index for Babies (CRIB II). Method: This cross-sectional, descriptive-analytical, longitudinal study was conducted on 344 preterm neonates with the gestational age of 23-32 weeks and birth weight of 500-1500 g in a referral center in Tehran, Iran, from winter 2016 to spring 2017. Some neonatal variables were completed within the first 12 h of life, and the final scores were calculated based on CRIB II. Then, the correlation of these variables with mortality outcome was evaluated using logistic regression. Sensitivity, specificity, and positive and negative values were also calculated via SPSS software (version 23). Results: According to the results, 253 (73.57%) neonates, including 122 girls (48%), survived in the first 24 h after birth. The tot...
BMC Pediatrics
Background The 5-minute APGAR score is clinically used as a screening tool to assess how the newborn has reacted to previous care, remaining relevant for predicting neonatal survival. This study aimed to analyze the determinants of the 5th minute APGAR score, and the factors associated with the death and survival of newborns with low APGAR scores hospitalized in the neonatal intensive care unit (NICU) at a referral public hospital in North Brazil. Methods This was a hospital-based retrospective case-control study with 277 medical records. Newborns who presented with a 1-minute APGAR score < 7 followed by a 5-minute APGAR score < 7 were considered cases, while a score ≥ 7 was categorized as controls. Univariate and multivariable logistic regression analyses were used to establish the determinant factors of the low APGAR score and death outcome in this group. Survival curves were obtained using the Kaplan-Meier estimator, and then univariate and multivariate Cox regression was p...
Turkish Journal of Pediatric Disease, 2017
Objective: A number of illness severity scores have been established to predict mortality and morbidity in neonatal intensive care units (NICUs). The objective of this study was to compare SNAPPE-II (Scores for Neonatal Acute Physiology-Perinatal Extension-II) and CRIB-II (Clinical Risk Index for Babies-II), the latest versions of European and American scoring systems, in predicting hospital mortality and overall morbidity of surviving infants. Material and Methods: Very low birthweight infants (VLBW) admitted to the neonatal intensive care unit were identified. CRIB-II and SNAP-PE-II scores were electronically calculated for each patient via the website www.sfar.org. The receiver operating characteristics (ROC) curve was used to check the accuracy of the mortality and morbidity prediction. results: A total of 189 VLBW neonates (mean CRIB-II:9.9±3.8; mean SNAP-PE-II: 45.8±25.4) were evaluated. The mean birth weight, gestational age, CRIB-II, SNAP-PE-II scores were associated with mortality. Both CRIB-II and SNAP-PE-II were determined to be discriminatory for mortality, but not predictive enough for morbidity when evaluated with ROC curve analysis. conclusion: Both CRIB-II and SNAP-PE-II were found to be eligible in predicting hospital mortality of VLBW patients whereas their value was poor in predicting morbidity. CRIB-II, due to fewer parameters to evaluate, may be the preferred scoring system to predict mortality in NICUs with high patient capacity.
Quality of Life Research, 2016
Purpose To determine the relationship of Apgar scores, gestational age and neonatal risk mortality scores to healthrelated quality of life (HRQoL) for infants at the age of 8 months treated after birth in neonatal intensive care unit (NICU). Methods All surviving infants treated in two-third level NICUs in Rijeka, Croatia (from August 2013 to August 2014) were included in this prospective, cross-sectional study. For all neonates, the Score for Neonatal Acute Physiology (SNAP), SNAP with Perinatal Extension (SNAP-PE) and their simplified modifications (SNAP II and SNAP-PE II) were calculated. At the corrected age of 8 months, the Pediatric Quality of Life Questionnaire (PedsQL)-infant scale-was completed by parents of surviving infants. Multiple regression analysis was performed in order to assess the value of neonatal risk mortality scores, Apgar scores and gestational age as possible predictors of HRQoL, measured by questionnaire score. Results A strong correlation has been found between SNAP and 5-min Apgar scores to HRQoL. A positive correlation was also found between gestational age and HRQoL. Conclusion SNAP and 5-min Apgar scores are important outcome indicators, can aid clinicians' and parents' decision making on the benefits and burdens of acute medical interventions and help determine quantities of medical treatment. Educated medical staff, effective and efficient medical treatment and a high quality of care which prevent adverse events in the first minute of life should be a priority in efforts to improve the future quality of life.
Background: World over, Neonatal mortality has been used as an indicator for the health of the underfive population. There is a higher risk for a baby to have serious disability or even death, if the baby is born early. In 2013, about one third (36%) of infant deaths were due to pretermrelated causes (Prevention, 2017). Zambia's target is to reduce the neonatal mortality rate to less than 12 per 1,000 live births by 2021 . The main aim of this study was to assess the factors associated with mortality among neonates admitted in the Neonatal Intensive Care Unit at Methods: A cross-sectional retrospective audit was carried out to look at mortality records for neonates (at NICU-UTH, Lusaka, Zambia) from January 2015 to December 2017. A stratified random sampling method was used to select the study units. The data extraction form was used to collect the information from the neonatal mortality records chosen for the study. A total of 99 study participant files were extracted and used for this study. Stata version 14 was used to analyse the data.