Validity of Sick Neonatal Score (SNS) for predicting mortality in neonates admitted to a tertiary care centre

Dr.Aun karthik .T; Dr. Kamalarathnam C.N; Dr Ramya .S

Volume : VII, Issue : IV, April - 2017

Validity of Sick Neonatal Score (SNS) for predicting mortality in neonates admitted to a tertiary care centre

Dr. Aun Karthik . T, Dr. Kamalarathnam C. N, Dr Ramya . S

Abstract :

BACKGROND

In India there is a paucity of studies which have analysed the degree of illness at admission and its relation to outcome. This study was done to correlate the degree of sickness of a neonate at arrival as assessed by sick neonatal score with outcome.

OBJECTIVE

To validate SNS for predicting mortality in neonates admitted in a tertiary care centre and the role of prior stabilization of sick neonates before transport.

METHODS

This retrospective observational study was conducted in a tertiary care government neonatal unit in south India . All neonates admitted to the hospital between July 2016 – Dec 2016 were included. All baseline characteristics , transport details and SNS were obtained from emergency room form.

RESULTS

Emergency room forms of 1142 neonates were reviewed. Most neonates were ought from home (21.2%).108 Neonatal ambulance( 49.2%) was the predominant mode of transport, followed by private ambulance(12.3%). The average SNS for all neonates was 12.2 while it was 9.18 for those who expired & 12.9 for those who were discharged. An ROC showed the cut off value of SNS for predicting the mortality as ≤ 12 with a sensitivity of 85.41% and a specificity of 84.37%. Among the neonates with SNS < 12, prior stabilisation was associated with a favourable outcome(p<0.001). Need for immediate cardiorespiratory support post transport was associated with very poor outcome [OR 26.06(15.69,43.28) ].

CONCLUSION

SNS is a useful scoring system to predict outcome of sick neonates and sick neonates transported with prior stabilization had a favourable outcome