title: Predicting mortality in infants with persistent pulmonary hypertension of the newborn with the Score for Neonatal Acute Physiology-Version II (SNAP-II) in Thai neonates.
abstract: To evaluate the ability of the Score for Neonatal Acute Physiology-Version II (SNAP-II) to predict mortality in infants with persistent pulmonary hypertension of the newborn (PPHN).
  
  
  
  A prospective cohort study of 41 infants with PPHN admitted to our neonatal intensive care unit between June 2008 and March 2010, who underwent a SNAP-II test within 12 h of admission.
  
  
  
  Of the 41 infants, 14 died (34.1%) and 27 survived (65.9%). The SNAP-II scores were significantly higher in infants who died (50.1 ± 18.5 vs. 35.7 ± 16.8, P=0.02). Each point increase in the SNAP score increased the odds of mortality by 1.04 [95% confidence interval (CI) 1.01-1.07, P<0.01]. Infants who had a SNAP-II score of ≥ 43 had the greatest mortality risk with an odds ratio (OR) of 10.00 (95% CI 1.03-97.50). The SNAP-II model showed moderate discrimination in predicting mortality with a result of 0.72 (95% CI 0.56-0.88) under the receiver operating characteristic curve. The lowest blood pressure, lowest PaO(2)/FIO(2) ratio, and urine output within the first 12 h of admission were also independently found to be good predictors of an increased risk for death.
  
  
  
  The SNAP-II scoring system significantly predicted mortality. PPHN infants with a SNAP-II score of ≥ 43 had the greatest mortality risk.
authors.affiliation: Neonatal Intensive Care Unit, Hat Yai Medical Education Center, Hat Yai Hospital, Songkhla, Thailand. nnakwan@hotmail.com
authors.forename: Narongsak
authors.initials: N
authors.lastname: Nakwan
authors.forename: Narongwit
authors.initials: N
authors.lastname: Nakwan
authors.forename: Jeerawan
authors.initials: J
authors.lastname: Wannaro
mesh_terms: D001794:Blood Pressure; D015331:Cohort Studies; D006801:Humans; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal; D016017:Odds Ratio; D010100:Oxygen / Q000097:blood; D010547:Persistent Fetal Circulation Syndrome / Q000401:mortality*; D011446:Prospective Studies; D012372:ROC Curve; D012720:Severity of Illness Index; D013785:Thailand / Q000453:epidemiology; D014556:Urine
chemical_list: D010100:Oxygen