Predicting Outcome in Persistent Pulmonary Hypertension of the Newborn with Score for Neonatal Acute Physiology- Version II (SNAP-II)
Authors: Huu Hieu Nguyen , Minh Dien Tran , Thi Ha Le 
Published: July 2022

Persistent pulmonary hypertension of the Newborn is a serious disease related to the adaptation of fetal circulation after birth. This study aims to determine the ability of Score for Neonatal Acute Physiology- version II (SNAP-II) for predicting outcome in neonates with persistent pulmonary hypertension of the newborn (PPHN). This prospective cohort study of 52 neonates with PPHN was carried out in the Neonatal Center and Surgical Intensive Care Unit, Vietnam National Children’s Hospital over a  period of 7 months (10/2020 to 4/2021). SNAP-II score was evaluated within the first 12 hours of admission. Outcome of treatment was recorded at the 28th day of treatment. The study results show that the mortality rate was 25.0%; 11.5% of the patients had to use ventilators; 28.8% of the patients used NO inhalers and 9;6% of the patients  required ECMO. SNAP-II score has the power of predicting mortality in PPHN with the area under the ROC curve of 0.76 (95% CI: 0.61- 092, p < 0.05). SNAP-II score ≥ 27 was calculated as cutoff for predicting mortality with the sensitivity of 92;3% and specificity of 53.8%. Each point increase in SNAP-II score increased the odd of mortality by 1.10 (95% CI: 1.03- 1.18, p< 0.05). SNAP-II score also has the ability of  predicting secondary outcome of PPHN: using ECMO (AUC 0.81). Notably, this study finds that the SNAP-II scoring system is a useful  and reliable tool  to predict mortality  of neonates with PPHN and to assess the need of  ECMO therapy.

Keywords: Persistent pulmonary hypertension of the newborn, Score for Neonatal Acute Physiology- version II, neonatal mortality.

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