The Comparison of Two Prognostic Scores PRISM III and SNAPPE II in A Neonatal Intensive Care Unit

Background: Newborn survival rates in neonatal intensive care units (NICUs) are influenced by various factors, including birth weight, gestational age, and physiological indicators of illness severity.Traditional assessments such as APGAR scores have proven inadequate for predicting outcomes, necessitating the development of scoring systems like PRISM III and SNAPPE II.This study aims to evaluate and compare the predictive accuracy of PRISM III and SNAPPE II scores in assessing mortality among critically ill neonates admitted to a NICU. Material & Methods:A prospective observational study was conducted at CSS Hospital, Subharti Medical College, Meerut, enrolling 120 neonates under 28 days of life between December 2022 and March 2024.Data were collected on demographic information, physiological parameters, and the scores calculated at admission and 24 hours later.Statistical analyses were performed using SPSS version 20.0 to assess the sensitivity, specificity, and predictive values of both scoring systems.Results: Among 117 enrolled neonates (74.36% males, 25.64% females), the overall survival rate was 67.52%.The SNAPPE II score at admission and 24 hours indicated higher sensitivity for predicting mortality (81.58% and 73.68%, respectively), while PRISM III scores demonstrated lower sensitivity (78.94% at admission and 68.42% at 24 hours).The ROC curve analysis revealed SNAPPE II's AUC at 0.81 at 24 hours, while PRISM III's AUC was 0.85, indicating slightly higher overall discriminatory power.However, SNAPPE II's superior sensitivity emphasizes its potential for earlier identification of at-risk neonates. Conclusion:The findings suggest that SNAPPE II is more effective in predicting neonatal mortality at 24 hours post-admission than PRISM III, highlighting its utility in clinical settings for timely risk stratification and intervention planning.The choice of scoring system should be tailored to the specific needs of the patient population and clinical environment, reinforcing the importance of accurate assessment tools in improving neonatal care outcomes.