Abstract
Background: The present study was conducted to determine the utility of Score for Neonatal Acute Physiology II (SNAP II) and
Score for Neonatal Acute Physiology with Perinatal Extension II (SNAPPE II) scoring systems as predictors of neonatal mortality
rate, and to compare the predictive value of these two methods.
Methods: In this prospective study data were gathered from infants admitted to the neonatal intensive care unit (NICU) of Imam
Hossein Medical Center, Tehran, Iran, from March 2015 to December 2015. In addition to demographic data, Apgar score at 5
minutes after birth, initial and final diagnosis, SNAP II, and SNAPPE II were recorded within 24 hours after admission to the NICU.
Results: One hundred ninety-one newborn infants entered into the study. Birth weight (2555 ± 722 g in survival group versus
1588 ± 860 g in expired group, P<0.001), and Apgar score more than 7 at 5 minutes after birth (99.4% in survival group versus
57.1% in expired group, P<0.001) were significantly related to the mortality rate. By analyzing the data using logistic regression,
it was found that SNAP II (area under the curve [AUC] = 0.992; 95% CI: 0.98–1) and SNAPPE II (AUC = 0.994; 95% CI: 0.984–1)
had better value for predicting the patients’ survival compared to Apgar score at 5 minutes after birth (AUC = 0.711; 95% CI:
0.568–0.855). There was no statistically significant difference in predictive value of SNAP II and SNAPPE II methods (P>0.99).
Conclusion: According to our findings SNAP II and SNAPPE II are useful tools in predicting the mortality rate among Iranian
neonates admitted to NICU. Although there was no significant difference between SNAP II and SNAPPE II, both methods had a
much better predictive value compared to Apgar score at 5 minutes after birth.