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Predicting Outcome in Neonatal Hypoxic Respiratory Failure with the Score for Neonatal Acute Physiology (SNAP) and Highest Oxygen Index (OI) in the First 24 Hours of Admission

Journal of Perinatology volume 24, pages 376–381 (2004)Cite this article

Abstract

OBJECTIVE: To determine the clinical utility of SNAP score versus the highest oxygen index (OI) in first 24 hours of admission in predicting outcome of HRF.

STUDY DESIGN: All admissions (1991 to 1999) ≥36 weeks gestation, ventilated for ≥12 hours with FiO2≥0.50, without congenital anomalies were reviewed. Primary outcome measure was survival (without ECMO) versus ECMO and/or death.

RESULTS: From 184 infants with HRF, 148 survived (without ECMO) versus 36 died and/or received ECMO. SNAP score and highest OI were similar in predicting outcome of HRF (area under ROC curve: 0.813±0.037 versus 0.814±0.041; P=0.72). Death and/or ECMO requirement were best predicted by a SNAP score of 19 (Sensitivity 75.0%, Specificity 71%) or an OI of 28 (Sensitivity 75.0%, Specificity 76.4%).

CONCLUSION: Although both, the SNAP score and highest OI, are useful and similar in predicting outcome of HRF, OI is preferable because of its ease of use. We believe the predictive value of these parameters should be evaluated in a multicenter setting.

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Authors and Affiliations

  1. Department of Pediatrics, MetroHealth Medical Center and Case Western Reserve University (CWRU), Cleveland, OH, USA

    Deepak Kumar MD, Dennis M Super MD, MPH & John J Moore MD

  2. Chester Summer Scholar, MetroHealth Foundation, MetroHealth Medical Center, Cleveland, OH, USA

    Rudolph A Fajardo

  3. Department of Pediatrics, Rainbow Babies and Children's Hospital, University Hospitals of Cleveland and CWRU, Cleveland, OH, USA

    Eileen E Stork MD & Firas A Saker MD

Authors
  1. Deepak Kumar MD
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  2. Dennis M Super MD, MPH
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  3. Rudolph A Fajardo
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  4. Eileen E Stork MD
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  5. John J Moore MD
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  6. Firas A Saker MD
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Additional information

Presented in part at the Pediatric Academic Societies and American Academy of Pediatrics Joint Meeting in Boston, MA, May 12–16, 2000.

Supported in part by the General Clinical Research Center (GCRC) Grant from NIH (MO1RR00080) awarded to the MetroHealth Medical Center, CWRU, Cleveland, OH, USA.

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Kumar, D., Super, D., Fajardo, R. et al. Predicting Outcome in Neonatal Hypoxic Respiratory Failure with the Score for Neonatal Acute Physiology (SNAP) and Highest Oxygen Index (OI) in the First 24 Hours of Admission. J Perinatol 24, 376–381 (2004). https://doi.org/10.1038/sj.jp.7211110

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