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A neonatal sequential organ failure assessment score predicts mortality to late-onset sepsis in preterm very low birth weight infants
Open accessAbstract
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-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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Late-onset Sepsis in Extremely Premature Infants
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Metadata
- Authors
- Wynn, J. L., & Polin, R. A.
- Affiliations
- University of Florida Health (US)
- Columbia University Irving Medical Center (US)
- Corresponding author
- Wynn, James L.
- Venue
- Pediatric Research
- Published
- 2019-08-08
- Volume
- 88
- Issue
- 1
- Pages
- 85-90
- ISSN
- 0031-3998 (ISSN-L)
- 1530-0447
- 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
- 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 › Pediatrics, Perinatology and Child Health › Neonatal and Maternal Infections
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › 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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