A Neonatal Sequential Organ Failure Assessment Score as a Predictor of Mortality in Neonates with Late-Onset Sepsis

Abstract

Background Late onset neonatal sepsis (LOS) is an important problem in neonatal intensive care units (NICUs).The occurrence of multi-organ dysfunction can result in mortality in neonates with LOS. Many scores are being developed to predict mortality in neonates with LOS. Aim Our aim was to test the validity of neonatal sequential organ failure assessment score (nSOFA) to identify NICU patients at a high risk of mortality among those with LOS dependent on routinely collected data . Patients and Methods This prospective observational study was conducted on neonates with late onset sepsis. Full history taking and complete clinical examination was undertaken. Complete blood count (CBC) including total leukocytic count (TLC), C- reactive protein (CRP) and blood culture were withdrawn from included neonates. nSOFA score was calculated for all included neonates using data from patients records. nSOFA score is a noval objective score that detect organ dysfunction in neonates with late onset sepsis, and used to identify the risk of mortality using data from patients records. Results The obtained results showed that, neonates who did not survive had significantly higher CRP and TLC significantly lower platelet count than those who survived. Also, neonates who did not survive had significantly higher median nSOFA score than survivors. In the current study, the sensitivity of nSOFA score on presentation to predict mortality in LOS neonates was 84.21% and its specificity was 80.39% with area under the curve (AUC) was 0.890%.Also positive predictive value PPV was 61.5% and negative predictive value NPV was 93.2%. Conclusion The nSOFA can be useful in predicting mortality in neonates with LOS. Further studies are needed to assess its utility in different gestational age groups.