Document Detail

Score for neonatal acute physiology II predicts mortality and persistent organ dysfunction in neonates with severe septicemia.
MedLine Citation:
PMID:  19430085     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To investigate the relationship between score for neonatal acute physiology II (SNAP II) applied within 12 hours from the onset of severe sepsis, and death and persistent organ dysfunction (OD).
DESIGN: Prospective cohort study.
SETTING: Level III neonatal intensive care unit.
PARTICIPANTS: Neonates with severe sepsis.
INTERVENTION: SNAP II was applied within the first 12 hours from the onset of severe sepsis. Neonates with major malformations, severe asphyxia and prior blood products were excluded. MAJOR OUTCOME MEASURE: Death at day 14 from enrolment.
RESULTS: Forty neonates completed the study. Twenty-five died within 14 days. The median SNAP II was significantly higher in babies who died versus those who survived [median (IQR): 43 (36-53.5) vs 18 (16-37), P<0.001]. A SNAP II greater than 40 had 88% positive predictive value for death and persistent OD each, and 86.6% and 86% specificity for death and persistent OD, respectively. On day 14 from enrolment, more organs normalized/improved in the subjects with SNAP II of < or = 40. Perfusion related SNAP II parameters were significantly associated with death and organ dysfunction.
CONCLUSIONS: Severely septicemic neonates with high SNAP II scores (>40) have a higher risk of dying and persistent organ dysfunction. Individual SNAP II parameters do not contribute equally in prediction of mortality.
Venkataseshan Sundaram; Sourabh Dutta; Jasmina Ahluwalia; Anil Narang
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Publication Detail:
Type:  Journal Article     Date:  2009-04-01
Journal Detail:
Title:  Indian pediatrics     Volume:  46     ISSN:  0974-7559     ISO Abbreviation:  Indian Pediatr     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-10-08     Completed Date:  2010-02-01     Revised Date:  2014-07-30    
Medline Journal Info:
Nlm Unique ID:  2985062R     Medline TA:  Indian Pediatr     Country:  India    
Other Details:
Languages:  eng     Pagination:  775-80     Citation Subset:  IM    
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MeSH Terms
Cohort Studies
Infant, Newborn
Infant, Newborn, Diseases / diagnosis*,  pathology
Intensive Care Units, Neonatal
Multiple Organ Failure / diagnosis*,  pathology
Neonatology / methods*
Prospective Studies
Risk Assessment
Sepsis / diagnosis*,  pathology
Severity of Illness Index
Survival Analysis
Comment In:
Indian Pediatr. 2010 Apr;47(4):366; author reply 367   [PMID:  20431178 ]
Indian Pediatr. 2010 Apr;47(4):366; author reply 367   [PMID:  20431179 ]
Indian Pediatr. 2009 Sep;46(9):765-6   [PMID:  19812421 ]

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