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Objective <p>Assess the utility of the neonatal sequential organ failure assessment score (nSOFA) for evaluation-specific mortality discrimination in all late-onset infection (LOI) evaluations.</p> Methods <p>Retrospective Cohort of all neonates who had an LOI evaluation from 2012 to 2023 in a single level IV Academic NICU in Florida, USA. The primary outcome was LOI-evaluation-specific mortality.</p> Results <p>1481 neonates had 2916 LOI evaluations with a 3.8% mortality rate. The AUROC for the nSOFA score at evaluation was 0.76 (95% CI 0.71–0.81) and improved to 0.82 (95% CI 0.78–0.87) six hours after. nSOFA ≥2 within 6 h of the start of the LOI was 87% sensitive and 66% specific, with a 99% NPV for mortality, <i>p</i> &lt; 0.0001.</p> Conclusions <p>The nSOFA score had good to excellent mortality discrimination at the LOI evaluation level. These results solidify the utility of the nSOFA score as the foundation for a consensus definition of neonatal sepsis.</p>

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The utility of neonatal sequential organ failure assessment in mortality risk in all neonates with suspected late-onset infection

  • 期刊论文

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  • 发表日期：

    2025年4月18日

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  • Faris N. Al Gharaibeh,
  • Star Liu,
  • James L. Wynn,
  • Khyzer B. Aziz

摘要

Objective

Assess the utility of the neonatal sequential organ failure assessment score (nSOFA) for evaluation-specific mortality discrimination in all late-onset infection (LOI) evaluations.

Methods

Retrospective Cohort of all neonates who had an LOI evaluation from 2012 to 2023 in a single level IV Academic NICU in Florida, USA. The primary outcome was LOI-evaluation-specific mortality.

Results

1481 neonates had 2916 LOI evaluations with a 3.8% mortality rate. The AUROC for the nSOFA score at evaluation was 0.76 (95% CI 0.71–0.81) and improved to 0.82 (95% CI 0.78–0.87) six hours after. nSOFA ≥2 within 6 h of the start of the LOI was 87% sensitive and 66% specific, with a 99% NPV for mortality, p < 0.0001.

Conclusions

The nSOFA score had good to excellent mortality discrimination at the LOI evaluation level. These results solidify the utility of the nSOFA score as the foundation for a consensus definition of neonatal sepsis.