Neonatal acute physiology perinatal extension II score as a predictor of neonatal mortality in neonatal sepsis among Egyptian newborns

Background In underdeveloped nations, neonatal sepsis (NS) is a leading cause of neonatal mortality and morbidity, however, its diagnosis is challenging. Objectives This study aimed to evaluate the Neonatal Acute Physiology Perinatal Extension II (SNAPPE II) score as a predictor of neonatal mortality in NS. Patients and methods This was a cross–sectional study, conducted on 150 neonates who were admitted to the neonatal intensive care unit (NICU) of the Pediatric hospitals, Cairo University and Ahmed Maher Teaching Hospital who were diagnosed with NS. Thorough history taking and clinical and laboratory data were recorded to calculate the SNAPPE II score. Results The included patients had a mean gestational age of 35.4±3.4. The SNAPPE II score ranged from 0 to 54 with a median and IQR of 5 (0–28). Receiver operating characteristic analysis showed that the SNAPPE II score could be used as a predictive tool to discriminate the outcome at a cutoff level of greater than 30.5, with 87.1% sensitivity, 96.6% specificity, 96.2% positive predictive value and 88.2% negative predictive value with AUC = 0.98 and P value less than 0.001. Thirty-one (20.7%) of our patients died, they had statistically significant lower gestational age, lower weight, lower platelet count, and higher SNAPPE II scores with P values of 0.048, 0.001, less than 0.001, 0.015, and less than 0.001, respectively, they had greater scores regarding lowest mean airway pressure, lowest temperature, lowest PH, APGAR score, weight and small for gestational age with a P value less than 0.001. Conclusion The SNAPPE II score can be used as a predictive tool of neonatal mortality due to NS.