Prediction of Preterm Mortality with Late Onset Sepsis using the Neonatal Sequential Organ Failure Assessment Score in Suez Canal University Hospitals

Background: The fatal condition known as neonatal sepsis is characterized by life-threatening organ dysfunction brought on by a dysregulated immune response to infection, but there is no operational definition of organ dysfunction that is relevant to newborns and may foretell infection-related death.
Objective: The aim of the current study was the prediction of mortality risk factors in low birth weight (LBW) preterm infants with Late Onset Sepsis (LOS) in Neonatal Intensive Care Unit (NICU).
Patients and methods: A cross sectional analytical study conducted on LBW preterm newborns admitted at Neonatal Intensive Care Unit in Suez Canal University Hospitals, between June 2020 to May 2021 and diagnosed to have LOS; nSOFA scores were derived for those patients at multiple time points first at the time os sepsis evaluation then at 48 hours interval till death or discharge then comparing the peak score with the outcome. The score assesses respiratory, cardiovascular and hematological systems, with scores ranging from (0-8) (0-4) and (0-3) respectively.
Results: The study included 102 neonates; 30 (29%) non-survivors and 72 (71%) survivors. Males were affected more than females (58.82% vs 41.18%). At a cut-off point of more than 7, which was selected as the optimum criterion; the sensitivity obtained was 86.67%, the specificity was 98.61% and accuracy 94%. The area-under-ROC-curve was equal to 0.981 (95% CI: 0.933 - 0.998) with positive statistical significance (P<0.001).
Conclusion: NSOFA score can be used to predict death in LBW babies who have LOS. One of the most important steps towards better newborn sepsis outcomes is the prediction of LOS mortality.