新生儿及儿科序贯器官衰竭评估评分在足月危重新生儿中的应用价值。
Utility of the neonatal and pediatric sequential organ failure assessment scores in critically ill term neonates.
作者信息
Nicolas Lara, Wynn James L, de la Cruz Diomel
机构信息
Department of Pediatrics, College of Medicine, University of Florida, Gainesville, FL, United States.
出版信息
Front Pediatr. 2025 Apr 29;13:1546408. doi: 10.3389/fped.2025.1546408. eCollection 2025.
BACKGROUND
The pediatric sequential organ failure assessment (pSOFA) and neonatal SOFA (nSOFA) scores are used to assess organ dysfunction and predict mortality in critically ill children and neonates. However, their utility in predicting mortality in term neonates admitted to pediatric ICU/pediatric cardiac ICU (PICU/PCICU) and neonatal ICU (NICU) remains unknown.
METHODS
We conducted a single-center retrospective cohort study of electronic health records of 4,403 and 379 term neonates admitted to NICU and PICU/PCICU, respectively. Hourly pSOFA and nSOFA scores were calculated. The primary outcome was in-hospital mortality. The area under the receiving operating characteristic curve (AUROC) for mortality was calculated.
RESULTS
Both scores predicted mortality in both settings (AUROC range, 0.79-0.95). The pSOFA showed a larger difference between survivors and non-survivors in the PICU/PCICU cohort, while nSOFA captured critical mortality risk factors in neonates across both settings.
CONCLUSIONS
Both pSOFA and nSOFA predicted mortality with good to very good discrimination in critically ill term neonates admitted to PICU/PCICU and NICU settings.
背景
儿科序贯器官衰竭评估（pSOFA）和新生儿序贯器官衰竭评估（nSOFA）评分用于评估危重症儿童和新生儿的器官功能障碍并预测死亡率。然而，它们在预测入住儿科重症监护病房/儿科心脏重症监护病房（PICU/PCICU）和新生儿重症监护病房（NICU）的足月儿死亡率方面的效用尚不清楚。
方法
我们分别对入住NICU和PICU/PCICU的4403例和379例足月儿的电子健康记录进行了单中心回顾性队列研究。计算每小时的pSOFA和nSOFA评分。主要结局是院内死亡率。计算死亡率的受试者工作特征曲线下面积（AUROC）。
结果
两种评分在两种情况下均能预测死亡率（AUROC范围为0.79 - 0.95）。在PICU/PCICU队列中，pSOFA在幸存者和非幸存者之间显示出更大的差异，而nSOFA在两种情况下均捕捉到了新生儿的关键死亡风险因素。
结论
pSOFA和nSOFA在预测入住PICU/PCICU和NICU的危重症足月儿死亡率方面具有良好到非常好的区分度。
Zotero 插件