Abstract:

Objective To explore the predictive value of neonatal sequential organ failure assessment (nSOFA) score for the death risk of late-onset sepsis in very/extremely low birth weight infants. Methods The clinical data of very/extremely low birth weight infants diagnosed with late-onset sepsis admitted from January 2017 to December 2021 were retrospectively analyzed. The nSOFA score was calculated at 5 time points (T-24, T-12, T0, T12, T24) before and after the diagnosis of sepsis. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of nSOFA score for mortality risk of children. Results A total of 135 children (66 boys and 69 girls) were included, and the age at diagnosis of sepsis was 21.0 (13.5-25.0) days. One hundred and thirteen children survived and 22 died (case fatality rate 16.3%). There were statistically significant differences in nSOFA scores between survival group and death group at T-12, T0, T12 and T24 time points (P<0.05). ROC curve analysis showed that the sensitivity of nSOFA score at T-12, T0, T12 and T24 to predict the death risk of late-onset sepsis in very/extremely low birth weight infants was 59.1%, 81.8%, 93.2% and 98.3%, and the specificity was 63.6%, 71.7%, 73.7% and 89.9%, respectively. The areas under the curve were 0.64, 0.79, 0.89 and 0.95, respectively. The sensitivity, specificity and area under the curve of nSOFA score were the largest at T24. Conclusions The nSOFA score has a predictive value for the risk of death from late-onset sepsis in very/extremely low birth weight infants. The higher the nSOFA score, the greater the risk of death from sepsis.

Key words: sequential organ failure assessment, neonatal late-onset sepsis, very/extremely low birth weight infant, death