Department of Neonatology, KK Women's and Children's Hospital, Singapore, Singapore,
Duke-NUS School of Medicine, Singapore, Singapore,
Neonatology. 2023;120(6):796-800. doi: 10.1159/000533467. Epub 2023 Sep 27.
The discriminative utility of the neonatal sequential organ failure assessment (nSOFA) for early-onset sepsis (EOS) mortality in the neonatal intensive care unit (NICU) is unknown.
The objective of the study was to determine the utility of nSOFA for EOS mortality.
Multicenter, retrospective cohort study of NICU patients with EOS between 2012 and 2023. nSOFA scores of survivors and non-survivors were compared, and area under the receiver operating characteristics curve (AUROC) for mortality was calculated.
104 subjects were identified (88 lived, 16 died). AUROC at blood culture collection (T0), 6 h after collection (T6), and the maximum nSOFA at T0 or T6 (T0-6max) were 0.76 (95% CI: 0.62, 0.91), 0.89 (0.80, 0.99), and 0.87 (0.77, 0.97), respectively. Analyses restricted to birthweight (<1.5, <1 kg) or gestational age (<32, <29 week) cutoffs revealed AUROC ranges of 0.86-0.92 for T6 and 0.82-0.84 for T0-6max.
The nSOFA showed good-to-excellent discrimination of mortality among infants with EOS in the NICU.
新生儿序贯器官衰竭评估（nSOFA）在新生儿重症监护病房（NICU）对早发性败血症（EOS）死亡率的鉴别作用尚不清楚。
本研究旨在确定 nSOFA 对 EOS 死亡率的预测价值。
对 2012 年至 2023 年期间在 NICU 中患有 EOS 的患儿进行多中心回顾性队列研究。比较存活组和死亡组患儿的 nSOFA 评分，并计算死亡率的受试者工作特征曲线下面积（AUROC）。
共纳入 104 名患儿（88 例存活，16 例死亡）。血培养采集时（T0）、采集后 6 小时（T6）和 T0 或 T6 时最大 nSOFA（T0-6max）的 AUROC 分别为 0.76（95%CI：0.62，0.91）、0.89（0.80，0.99）和 0.87（0.77，0.97）。根据出生体重（<1.5，<1kg）或胎龄（<32，<29 周）的切点进行分析，T6 时的 AUROC 范围为 0.86-0.92，T0-6max 时的 AUROC 范围为 0.82-0.84。
nSOFA 对 NICU 中患有 EOS 的婴儿的死亡率具有良好到优秀的鉴别能力。
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