A neonatal sequential organ failure assessment score predicts mortality to late-onset sepsis in preterm very low birth weight infants

Wynn, James L.; Polin, Richard A.

doi:10.1038/s41390-019-0517-2

Cited by 169Neonatal and Maternal InfectionsSepsis Diagnosis and TreatmentInfant Development and Preterm Care

A neonatal sequential organ failure assessment score predicts mortality to late-onset sepsis in preterm very low birth weight infants

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Wynn, James L., Polin, Richard A.·2020·Pediatric Research

DOI 10.1038/s41390-019-0517-2PMC PMC7007331

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Abstract

Background An operational definition of organ dysfunction applicable to neonates that predicts mortality in the setting of infection is lacking. We determined the utility of an objective, electronic health record (EHR)-automated, neonatal sequential organ failure assessment (nSOFA) score to predict mortality from late-onset sepsis (LOS) in premature, very low birth weight (VLBW) infants.Methods Retrospective, single-center study of bacteremic preterm VLBW newborns admitted between 2012 and 2016. nSOFA scores were derived for patients with LOS at multiple time points surrounding the sepsis evaluation.Results nSOFA scores at evaluation and at all points measured after evaluation were different between survivors and non-survivors. Among patients with an nSOFA score of >4, mortality was higher at evaluation (13% vs 67%, p < 0.001), +6 h (15% vs 64%, p = 0.002), and +12 h (7% vs 71%, p < 0.001) as compared to patients with a score of ≤4. Receiver operating characteristics area under the curve was 0.77 at evaluation (95% CI 0.62-0.92; p = 0.001), 0.78 at +6 h (0.66-0.92; p < 0.001), and 0.93 at +12 h (0.86-0.997; p < 0.001).Conclusions The nSOFA scoring system predicted mortality in VLBW infants with LOS and this automated system was integrated into our EHR. Prediction of LOS mortality is a critical step toward improvements in neonatal sepsis outcomes.

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Life-threatening neonatal organ dysfunction in the respiratory, cardiovascular, and hematologic systems can be quantified by the neonatal Sequential Organ Failure Assessment (nSOFA).
“Life-threating neonatal organ dysfunction in the respiratory, cardiovascular, and hematologic systems can be quantified by the neonatal Sequential Organ Failure Assessment (nSOFA) (10).”
From Association of the neonatal sequential organ failure assessment score with neurological outcomes in infants diagnosed with hypoxic-ischemic encephalopathy (2026) · cites this paper as [10]

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Authors: Wynn, J. L., & Polin, R. A.
Affiliations: University of Florida Health (US)
Columbia University Irving Medical Center (US)
Corresponding author: Wynn, James L.
ORCID: Wynn, James L.
Polin, Richard A.
Venue: Pediatric Research
Publisher: Springer Science and Business Media LLC
Published: 2019-08-08
Volume: 88
Issue: 1
Pages: 85-90
ISSN: 0031-3998 (ISSN-L)
1530-0447
DOI: 10.1038/s41390-019-0517-2
PMC: PMC7007331
OpenAlex: W2966373709
Cited by: 169
References: 17
Citations by year: 2026: 31 · 2025: 23 · 2024: 20 · 2023: 24 · 2022: 34 · 2021: 24 · 2020: 13
FWCI: 16.34
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.springer.com/tdm (tdm)
www.springer.com/tdm (vor)
Locations: Pediatric Research (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: National Institute of General Medical Sciences (R01GM128452)
Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD089939)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Neonatal and Maternal Infections
Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Infant Development and Preterm Care
Keywords: late-onset sepsis, mortality prediction, organ dysfunction, bacteremia
MeSH terms: Neonatal Sepsis, Female, Humans, Infant, Newborn, Infant, Premature, Male, Retrospective Studies, Risk, ROC Curve, Severity of Illness Index, Case-Control Studies, Bacteremia, Disease Progression, Infant, Very Low Birth Weight, Electronic Health Records

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A neonatal sequential organ failure assessment score predicts mortality to late-onset sepsis in preterm very low birth weight infants

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