Xu Doudou, Dong Ziwei, Yin Xiaoli, Yang Yuanyuan, Wang Yang
Department of Pediatrics, The First Affiliated Hospital of Anhui Medical University, Hefei, China.
Front Pediatr. 2023 Sep 29;11:1233189. doi: 10.3389/fped.2023.1233189. eCollection 2023.
The neonatal sequential organ failure assessment (nSOFA) score is an operational definition of organ dysfunction employed to predict sepsis-associated mortality. However, the relationship between the nSOFA score and bronchopulmonary dysplasia (BPD) has not been investigated clearly. This study evaluates whether the nSOFA score within 72 h after delivery could be used to predict the occurrence of BPD in very preterm infants.
In this retrospective, single-center cohort study, preterm infants born between 2019 and 2021 were investigated, the nSOFA score was calculated from medical records after admission to the neonatal intensive care unit (NICU) within 72 h after delivery, and the peak value was used for calculation. A logistic regression model was used to evaluate the relationship between the nSOFA score and BPD. Propensity score matching and subgroup analysis were performed to verify the reliability of the results.
Of 238 infants meeting the inclusion criteria, 93 infants (39.1%) were diagnosed with BPD. The receiver operating characteristic curve of the nSOFA score in predicting BPD was 0.790 [95% confidence interval (CI): 0.731-0.849]. The logistic regression model showed that an increment of one in the nSOFA score was related to a 2.09-fold increase in the odds of BPD (95% CI: 1.57-2.76) and 6.36-fold increase when the nSOFA score was higher than 1.5 (95% CI: 2.73-14.79).
The nSOFA score within 72 h after delivery is independently related to BPD and can be used to identify high-risk infants and implement early interventions.
新生儿序贯器官衰竭评估(nSOFA)评分是用于预测脓毒症相关死亡率的器官功能障碍的操作性定义。然而,nSOFA评分与支气管肺发育不良(BPD)之间的关系尚未得到明确研究。本研究评估分娩后72小时内的nSOFA评分是否可用于预测极早产儿BPD的发生。
在这项回顾性单中心队列研究中,对2019年至2021年出生的早产儿进行调查,在分娩后72小时内新生儿重症监护病房(NICU)入院后的病历中计算nSOFA评分,并使用峰值进行计算。采用逻辑回归模型评估nSOFA评分与BPD之间的关系。进行倾向评分匹配和亚组分析以验证结果的可靠性。
在238例符合纳入标准的婴儿中,93例(39.1%)被诊断为BPD。nSOFA评分预测BPD的受试者工作特征曲线为0.790[95%置信区间(CI):0.731 - 0.849]。逻辑回归模型显示,nSOFA评分每增加1分,BPD发生几率增加2.09倍(95% CI:1.57 - 2.76),当nSOFA评分高于1.5时增加6.36倍(95% CI:2.73 - 14.79)。
分娩后72小时内的nSOFA评分与BPD独立相关,可用于识别高危婴儿并实施早期干预措施。