The predicting value of two kinds of score for acute physiology in the treatment outcome of necrotizing enterocolitis

Abstract

Objective To study the value of score for neonatal acute physiology Ⅱ(SNAP Ⅱ) and its extension version Ⅱ(SNAPPE-Ⅱ) in predicting neonatal necrotizing enterocolitis (NEC) outcome. Methods We explored 73 NEC patients by statistics who were treated in our hospital from January 2002 to January 2012. The patients were divided into two groups: surgery group and non-surgery group, then they were divided into subgroups: alive group and death group. The general information including birth weight, age, clinical manifestations, treatment of patients were collected. Every patient was checked and scored by the methods SNAP-Ⅱ and SNAPPE-Ⅱ in time. Results The scores (27.0±2.3, 26.5±1.8) of surgery group including SNAP-Ⅱ and SNAPPE-Ⅱ were higher than those (14.0±2.1, 15.0±2.5) in the non-surgery group (P<0.01). The scores (31.0±3.2, 31.0±3.4) of the death group including SNAP-Ⅱ and SNAPPE-Ⅱ were higher than those (11.0±2.5, 10.0±3.6) in the alive group (P<0.01). According to the area under the curve (AUC) analyzed by the receiver operating characteristic (ROC) curve for measuring the scores of surgery predicting, AUC was 0.726 for SNAP-Ⅱ and 0.732 for SNAPPE-Ⅱ. The value of predicting surgery risk was 20 and 24 respectively. According to the AUC analyzed by the ROC curve for measuring the scores for surgery predicting, AUC was 0.752 for SNAP-Ⅱ and 0.825 for SNAPPE-Ⅱ. The value of predicting mortality risk was 31 and 33 respectively. All P values were less than 0.01 and there were significant differences. Conclusion The two kinds of score for neonatal acute physiology have an important significance in predicting surgery and mortality risk of NEC. Key words: Necrotizing enterocolitis; Neonate