Diagnostic accuracy of score for neonatal acute physiology II (Snap II) in prediction of mortality in neonates with sepsis

Background: neonatal sepsis is a clinical syndrome of systemic illness accompanied by bacteremia occurring in the first month of life. various scoring systems and clinical risk index for babies have been used to assess severity of illness in newborns. objective: the objective of this study was to assess the diagnostic accuracy of snap ii in prediction of mortality in neonates with sepsis. methods: this cohort study was conducted in neonatal icu of pediatrics,king edward medical university,lahore,pakistan. two hundred and fifty neonates fulfilling case definition of sepsis were assessed using snap ii at the time of admission. severity of illness was graded according to snapii score (mild: 1-20,moderate: 21-40,severe: >40). all neonates were followed up until recovery or death,whichever was earlier,up to a maximum of 14 days. the diagnostic accuracy of snap ii was calculated by taking mortality of neonate as gold standard. results: mean age of neonates was 7.53±6.64days. the male to female ratio was 2.25:1. the sensitivity,specificity,ppv and npv of snap ii was 68.5%,90.7%,80.3% and 83.9% respectively. the overall diagnostic accuracy of snap ii was 82.8%. conclusion: at snap ii of ≥40,neonates with sepsis are at significantly higher risk of mortality. © 2007 pakistan pediatric journal. all rights reserved.