Document Detail


Interinstitutional variation in prediction of death by SNAP-II and SNAPPE-II among extremely preterm infants.
MedLine Citation:
PMID:  19858146     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Illness severity scores predict death among infants admitted to NICUs. We know of no study limited to a population defined by an extremely low gestational age. METHODS: A total of 1467 infants born before the 28th postmenstrual week at 14 institutions were given Score for Neonatal Acute Physiology II (SNAP-II) and Score for Neonatal Acute Physiology Perinatal Extension II (SNAPPE-II) values based on data collected within the first 12 postnatal hours. All deaths in the intensive care nursery were identified. RESULTS: The rate of death before postnatal day 28 was 13% (interinstitutional range: 7%-20%), whereas the overall mortality rate was 18% (8%-31%). SNAP-II values, SNAPPE-II values, and mortality rates tended to decrease with increasing gestational age. Even within gestational age strata, however, the risk of death decreased with decreasing SNAP-II and SNAPPE-II values. The positive predictive values of most SNAP-II and SNAPPE-II cutoff levels were close to 30%. In general, institutions' mortality rates increased with the proportions of infants whose SNAP-II values were >/=30. CONCLUSION: The physiologic instability in the first 12 postnatal hours that is identified by illness severity scores conveys information about the risk of death among infants at the lowest gestational ages.
Authors:
Olaf Dammann; Bhavesh Shah; Mary Naples; Francis Bednarek; John Zupancic; Elizabeth N Allred; Alan Leviton;
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2009-10-26
Journal Detail:
Title:  Pediatrics     Volume:  124     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-10-27     Completed Date:  2009-12-31     Revised Date:  2010-09-27    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e1001-6     Citation Subset:  AIM; IM    
Affiliation:
Division of Newborn Medicine, Floating Hospital for Children at Tufts Medical Center, Boston, Massachusetts 02111, USA. odammann@tuftsmedicalcenter.org
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MeSH Terms
Descriptor/Qualifier:
Gestational Age
Hospital Mortality
Humans
Infant Mortality*
Infant, Extremely Low Birth Weight
Infant, Newborn
Infant, Premature*
Intensive Care Units, Neonatal
Risk Factors
Severity of Illness Index*
Grant Support
ID/Acronym/Agency:
1-U01-NS40069-01A2/NS/NINDS NIH HHS; P30-HD18655/HD/NICHD NIH HHS; U01 NS040069-05/NS/NINDS NIH HHS
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