Accuracy of Scoring Systems for Risk Assessment in Neonatal Intensive Care Unit

Study Overview
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Brief Summary
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Early detection of neonates with higher risk of death is quite important for paying more attention to these cases, timely referral to tertiary neonatal intensive care unit (NICU), and provision of meticulous critical care, which ultimately may improve outcomes. Several scoring systems have recently been developed for assessment of the intensity of illness and prognosticate the risk of not only neonatal mortality but also short- and long-term morbidities. The accuracy of these scoring systems has been investigated in several NICUs from different countries, such as USA, UK, Canada, Brazil, India, and Iran. Previous Egyptian studies have investigated the accuracy of Clinical Risk Index for Babies II (CRIB II), Score for Neonatal Acute Physiology II (SNAP-II) and its Perinatal Extension II (SNAPPE-II). However, the accuracy of Sensorium, temperature, oxygenation, perfusion, skin color, and blood sugar (STOPS), Modified Sick neonatal Score (MSNS), and neonatal sequential organ failure assessment (nSOFA) has not been investigated in Egyptian NICUs. Therefore, more studies are required to investigate the utility and accuracy of neonatal risk assessment scores in Egyptian NICUs.

Official Title
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Accuracy of Scoring Systems for Risk Assessment in Neonatal Intensive Care Unit at Sohag University Hospital

Conditions
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Neonatal Death

Intervention / Treatment
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* Other: CRIB II
* Other: SNAP-II
* Other: SNAPPE-II
* Other: STOPS
* Other: MSNS
* Other: nSOFA


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Admission within 24 hours after birth. Length of hospital stay at the first admission to NICU ≥12 hours Exclusion Criteria: Major congenital anomalies. Discharge against medical advice Transportation to other places. Missing data on items of scoring systems

Ages Eligible for Study
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Maximum Age: 28 Days

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Study participants<br>Neonates admitted to NICU and fulfilling eligibility criteria | Other: CRIB II<br>* Calculate Clinical Risk Index for Babies II score<br>Other: SNAP-II<br>* Calculate Score for Neonatal Acute Physiology II<br>Other: SNAPPE-II<br>* Calculate Score for Neonatal Acute Physiology Perinatal Extension II<br>Other: STOPS<br>* Calculate Sensorium, temperature, oxygenation, perfusion, skin color, and blood sugar score<br>Other: MSNS<br>* Calculate Modified Sick neonatal Score<br>Other: nSOFA<br>* Calculate neonatal sequential organ failure assessment<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Survival at discharge | Proportion of neonates discharged alive from NICU | One year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Length of hospital stay | Length of stay in NICU | One year | 
| Need for CPAP | Proportion of neonates connected to continuous positive airway pressure | One year | 
| Need for invasive ventilation | Proportion of neonates requiring invasive ventilation | One year |