Department of Neonatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Ann Med. 2024 Dec;56(1):2426752. doi: 10.1080/07853890.2024.2426752. Epub 2024 Nov 9.
Neonatal illness severity scores are not extensively studied for their ability to predict mortality or morbidity in preterm infants. The aim of this study was to compare the Neonatal Sequential Organ Failure Assessment (nSOFA), Clinical Risk Index for Babies-II (CRIB-II), and Score for Neonatal Acute Physiology with Perinatal extension-II (SNAPPE-II) for predicting mortality and short-term morbidities in preterm infants ≤32 weeks.
In this retrospective study, infants born in 2017-2018 with gestational age (GA) ≤32 weeks were evaluated. nSOFA, CRIB-II, and SNAPPE-II scores were calculated for each patient, and the ability of these scores to predict mortality and morbidities was compared. The morbidities were categorized as mod/sev bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC) requiring surgery, early-onset sepsis (EOS), late-onset sepsis (LOS), retinopathy of prematurity (ROP) requiring treatment, and severe intraventricular hemorrhage (IVH). Calculating the area under the curve (AUC) on receiver operating characteristic curves (ROC) analysis to predict and compare scoring systems' accuracy.
A total of 759 preterm infants were enrolled, of whom 88 deceased. The median nSOFA, CRIB-II, and SNAPPE-II scores were 2 (0, 3), 6 (4, 8), and 13 (5, 26), respectively. Compared with infants who survived, these three scores were significantly higher in those who deceased ( < 0.05). For predicting mortality, the AUC of the nSOFA, SNAPPE-II, and CRIB-II were 0.90, 0.82, and 0.79, respectively. The nSOFA scoring system had significantly higher AUC than CRIB-II and SNAPPE-II ( < 0.05). However, short-term morbidities were not strongly correlated with these three scoring systems.
In infants ≤32 weeks gestation, nSOFA scoring system is more valuable in predicting mortality than SNAPPE-II and CRIB-II. However, further studies are required to assess the predictive power of neonatal illness severity scores for morbidity.
新生儿疾病严重程度评分在预测早产儿的死亡率或发病率方面的研究还不够广泛。本研究旨在比较新生儿序贯器官衰竭评估（nSOFA）、婴儿临床风险指数-Ⅱ（CRIB-Ⅱ）和新生儿急性生理学与围产期扩展评分-Ⅱ（SNAPPE-Ⅱ）在预测≤32 周早产儿死亡率和短期发病率方面的作用。
本回顾性研究纳入了 2017 年至 2018 年出生、胎龄（GA）≤32 周的婴儿。为每位患者计算 nSOFA、CRIB-Ⅱ和 SNAPPE-Ⅱ评分，并比较这些评分预测死亡率和发病率的能力。将发病率分为中度/重度支气管肺发育不良（BPD）、需要手术治疗的坏死性小肠结肠炎（NEC）、早发性败血症（EOS）、晚发性败血症（LOS）、需要治疗的早产儿视网膜病变（ROP）和严重脑室出血（IVH）。通过绘制受试者工作特征曲线（ROC）分析计算曲线下面积（AUC），以预测和比较评分系统的准确性。
共纳入 759 例早产儿，其中 88 例死亡。nSOFA、CRIB-Ⅱ和 SNAPPE-Ⅱ评分的中位数分别为 2（0，3）、6（4，8）和 13（5，26）。与存活的婴儿相比，死亡婴儿的这三个评分均显著升高（<0.05）。在预测死亡率方面，nSOFA、SNAPPE-Ⅱ和 CRIB-Ⅱ的 AUC 分别为 0.90、0.82 和 0.79。nSOFA 评分系统的 AUC 显著高于 CRIB-Ⅱ和 SNAPPE-Ⅱ（<0.05）。然而，短期发病率与这三个评分系统没有很强的相关性。
在胎龄≤32 周的婴儿中，nSOFA 评分系统在预测死亡率方面比 SNAPPE-Ⅱ和 CRIB-Ⅱ更有价值。然而，需要进一步的研究来评估新生儿疾病严重程度评分对发病率的预测能力。
