Comparison Between SNAPPE-II and CRIB-II Scoring Methods in Predicting Neonatal Mortality in the NICU

Swathi Onkarappa Nyamthi, Adarsh Dhavaleshwar, Santosh Soans

Abstract

Background and Aim: Mortality of neonates in the NICU can be predicted using several illness severity scoring methods that have evolved through time. Many studies have validated and compared the effectiveness of Score for Neonatal Acute Physiology with Perinatal Extension-II (SNAPPE-II) and Clinical Risk Index for Babies-II (CRIB-II) illness severity scores in predicting mortality. However, very few studies have compared the efficacy of SNAPPE-II and CRIB-II in predicting mortality in neonates admitted to the NICU. This study compared the efficacy of SNAPPE-II and CRIB-II in predicting mortality.

Materials and Methods: A total of 193 neonates, who met the inclusion criteria, were included in the study, and their SNAPPE-II and CRIB-II scores were computed. A receiver operating curve was drawn, and statistical analysis was performed using the SPSS software.

Results: Our study demonstrated that, regardless of gestational age, SNAPPE-II score has a remarkable association with mortality, indicating a statistically significant P value. The average SNAPPE-II score in neonates who died was 34.6 ± 6.45, whereas the score for those who survived was 7.32 ± 4.719. In neonates who survived, the CRIB-II score was between 1 and 19, with a mean of 6.5. In neonates who died, the CRIB-II score was between 5 and 19, with a mean of 11.87. These results suggest that SNAPPE-II and CRIB-II scores are directly proportional to mortality, that is, higher the score, higher the mortality risk. CRIB-II score has the predictive ability that is comparable to that of SNAPPE-II score, with an area under the curve of 0.783 compared with 0.74, respectively. There was no statistically significant difference between both the scoring methods.

Conclusion: Both SNAPPE-II and CRIB-II scoring methods can be used during the first 12 hours of life, and they both had comparable predictive values. However, CRIB-II scoring method is more preferred in preterm neonates.