PREDICTIVE ACCURACY OF CRIB-II AND SNAPPE-II SCORES FOR MORTALITY RISK IN PRETERM NEONATES

Abstract

Objective: To evaluate and compare the diagnostic performance of the CRIB-II and SNAPPE-II scoring systems in predicting mortality among preterm neonates.

Study Design: Cross sectional Validation study.

Study Setting: Department of Pediatrics, Benazir Bhutto Hospital, Rawalpindi.

Study Duration: Six Months (February to 14 July, 2025).

Methodology: This study included preterm neonates with a gestational age of less than 32 weeks and a birth weight below 1500 grams, selected through non-probability consecutive sampling. Both CRIB-II and SNAPPE-II scores were calculated within 12 hours of admission. Mortality risk was classified using cutoff values of ≥8.5 for CRIB-II and ≥27.5 for SNAPPE-II. Neonatal outcomes were monitored for 28 days. Diagnostic indicators such as sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), likelihood ratios, and the area under the receiver operating characteristic curve (AUC) were determined.

Results: Of the 122 neonates enrolled, 15 (12.3%) did not survive. The CRIB-II scores correctly identified 11 deaths, with a sensitivity of 73.33%, specificity of 79.44%, PPV of 33.33%, NPV of 95.51%, accuracy of 78.69%, and an AUC of 0.925. SNAPPE-II identified 12 deaths, demonstrating a sensitivity of 80.00%, specificity of 84.11%, PPV of 41.38%, NPV of 96.77%, accuracy of 83.61%, and an AUC of 0.952.

Conclusion: Both scoring systems demonstrated reliable diagnostic value for early mortality prediction in preterm neonates. In this cohort, SNAPPE-II exhibited superior overall performance.