Prognostic accuracy of Neonatal SOFA score versus SIRS criteria in preterm infants with late-onset sepsis

European Journal of Pediatrics · 4 authors, 3 centres

AI SUMMARY

FIDELITY 100%

This summary was generated by AI from a single paper. It has not been reviewed by a clinician and is not clinical advice. Verify against the source before acting on it.

AGENT 01 · STRUCTURED SUMMARY

TRACE TO SOURCE

“

TL;DR

This retrospective study compared the Neonatal SOFA (nSOFA) score and SIRS criteria for predicting sepsis-related mortality in 112 preterm infants with late-onset sepsis. The nSOFA score demonstrated significantly superior prognostic accuracy compared to SIRS criteria, with an AUC of 0.950 versus 0.569 at sepsis onset.

Full summary

570 CHARS

This retrospective single-center cohort study of 112 preterm infants with late-onset sepsis compared the prognostic accuracy of nSOFA and SIRS criteria for predicting sepsis-related mortality. ROC analysis at sepsis onset showed nSOFA AUC of 0.950 versus SIRS AUC of 0.569 (p = 0.0002), with an optimal nSOFA cutoff of 4 yielding sensitivity 92% and specificity 85%. In multivariate analysis, T0 and T1 nSOFA remained independently associated with mortality, while T1 SIRS did not. Non-survivors had higher rates of Gram-negative infections and greater organ impairment.

STUDY TYPE

cohort

SPECIALTY

pediatrics

SUMMARISED BY

AI pipeline

FIDELITY CHECK

100% · A

ORIGINAL PAPER

PMC10587306

Prognostic accuracy of Neonatal SOFA score versus SIRS criteria in preterm infants with late-onset sepsis

European Journal of Pediatrics

READ THE FULL PAPER

ABSTRACT

Abstract Neonatal SOFA score was reported as an accurate predictor of mortality while the prognostic accuracy of SIRS criteria is unknown. The aim was to compare neonatal SOFA and SIRS criteria for the prediction of late onset sepsis-related mortality in preterm newborns. Newborns ≤ 32 weeks with late onset sepsis were retrospectively studied. Neonatal SOFA and SIRS criteria were calculated at onset of sepsis (T0), and after 6 ± 1 (T1), 12 ± 3 (T2) and 24 ± 3 h (T3). Outcome was death during antibiotic treatment for late onset sepsis. We studied 112 newborns with gestational age 26.9 ± 2.3 weeks; 11% met the study outcome. Neonatal SOFA was significantly higher in non-survivors vs. survivors at all time intervals; SIRS criteria were significantly higher in non-survivors vs. survivors at T1, T2 and T3. Neonatal SOFA increased over time in non-survivors (p = 0.003). At T0, the area under receiver operating characteristics curve was significantly higher for neonatal SOFA score than SIRS criteria (0.950 vs. 0.569; p = 0.0002), and the best calculated cut-off for T0 neonatal SOFA score was 4. In multivariate analysis T0 and T1 neonatal SOFA were predictors of late onset sepsis-related mortality (p = 0.048 and p < 0.001). Conclusion: Neonatal SOFA score showed greater discriminatory capacity for mortality than SIRS criteria and might be helpful to plan management for patients at higher risk of death. What is Known: • Neonatal SOFA score may be an accurate prognostic tool. • No prognostic score has been fully standardized for septic newborns in NICU. What is New: • Neonatal SOFA score outperformed SIRS criteria for the prediction of prognosis in preterm infants with late onset sepsis. • Neonatal SOFA score assessed at onset of sepsis and 6 hrs later is a predictor of mortality. Supplementary Information The online version contains supplementary material available at 10.1007/s00431-023-05143-5. Keywords: Newborn, Preterm, Late onset sepsis, nSOFA, SIRS, Mortality

CITATION EXPORT

Chiara Poggi, Martina Ciarcià, Francesca Miselli et al.. Prognostic accuracy of Neonatal SOFA score versus SIRS criteria in preterm infants with late-onset sepsis. European Journal of Pediatrics. (2023). https://doi.org/10.1007/s00431-023-05143-5

AUTHORS

4 · 3 CENTRES

Chiara Poggi, Martina Ciarcià, Francesca Miselli, Carlo Dani

1Neonatal Intensive Care Unit, Department of Mother and Child Care, Careggi University Hospital, Florence, Italy
2Department of Neurosciences, Drug Research and Child Health, University of Florence, PsychologyFlorence, Italy
3Department of Clinical and Experimental Medicine, University of Modena and Reggio Emilia, Modena, Italy