Journal of perinatology : official journal of the California Perinatal Association · 2025
The utility of neonatal sequential organ failure assessment in mortality risk in all neonates with suspected late-onset infection.
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Al Gharaibeh Faris N, Liu Star, Wynn James L, Aziz Khyzer B
Аннотация
OBJECTIVE: Assess the utility of the neonatal sequential organ failure assessment score (nSOFA) for evaluation-specific mortality discrimination in all late-onset infection (LOI) evaluations.
METHODS: Retrospective Cohort of all neonates who had an LOI evaluation from 2012 to 2023 in a single level IV Academic NICU in Florida, USA. The primary outcome was LOI-evaluation-specific mortality.
RESULTS: 1481 neonates had 2916 LOI evaluations with a 3.8% mortality rate. The AUROC for the nSOFA score at evaluation was 0.76 (95% CI 0.71-0.81) and improved to 0.82 (95% CI 0.78-0.87) six hours after. nSOFA ≥2 within 6 h of the start of the LOI was 87% sensitive and 66% specific, with a 99% NPV for mortality, p < 0.0001.
CONCLUSIONS: The nSOFA score had good to excellent mortality discrimination at the LOI evaluation level. These results solidify the utility of the nSOFA score as the foundation for a consensus definition of neonatal sepsis.
METHODS: Retrospective Cohort of all neonates who had an LOI evaluation from 2012 to 2023 in a single level IV Academic NICU in Florida, USA. The primary outcome was LOI-evaluation-specific mortality.
RESULTS: 1481 neonates had 2916 LOI evaluations with a 3.8% mortality rate. The AUROC for the nSOFA score at evaluation was 0.76 (95% CI 0.71-0.81) and improved to 0.82 (95% CI 0.78-0.87) six hours after. nSOFA ≥2 within 6 h of the start of the LOI was 87% sensitive and 66% specific, with a 99% NPV for mortality, p < 0.0001.
CONCLUSIONS: The nSOFA score had good to excellent mortality discrimination at the LOI evaluation level. These results solidify the utility of the nSOFA score as the foundation for a consensus definition of neonatal sepsis.