ArticleBMJ paediatrics open2024
Assessing neonatal Sequential Organ Failure (nSOFA) scores in suspected late-onset neonatal sepsis among preterm infants: implications for morbidity and mortality.
Article in BMJ paediatrics open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Heterogeneity of Critical Organ Dysfunction During Late-Onset Bacteremia in Preterm Infants.JAMA network open · 2026Observational
- Severe Neonatal Infection in Crisponi Syndrome: A Diagnostic Challenge in a Preterm Infant.Cureus · 2026Article
- Neonatal Sepsis as Organ Dysfunction: Prognostic Accuracy and Clinical Utility of the nSOFA in the NICU-A Systematic Review.Diagnostics (Basel, Switzerland) · 2026Review
- Association of the neonatal sequential organ failure assessment score with neurological outcomes in infants diagnosed with hypoxic-ischemic encephalopathy.Frontiers in pediatrics · 2026Article
- The utility of neonatal sequential organ failure assessment in mortality risk in all neonates with suspected late-onset infection.Journal of perinatology : official journal of the California Perinatal Association · 2025Article
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8 authors.
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Abstract
backgroundThe neonatal Sequential Organ Failure Assessment (nSOFA) score is an organ dysfunction score developed for predicting mortality risk in preterm neonates with proven late-onset neonatal sepsis (LONS) and necrotising enterocolitis. However, the utility of the nSOFA score in determining the risk of retinopathy of prematurity (ROP), bronchopulmonary dysplasia (BPD) or mortality in patients with suspected LONS is unknown.
methodsWe performed a dual-centre retrospective cohort study of preterm (gestational age <32 weeks) neonates suspected of LONS, from 2016 to 2020 at two neonatal intensive care units. The nSOFA scores (range 0-15) were calculated for each suspected LONS episode at various time points around the sepsis evaluation. A nSOFA burden score was calculated, by counting each time point the nSOFA score was ≥4 during all sepsis episodes (in the time period -6 to 48 hours). The association with 10-day sepsis-related mortality and severe ROP and BPD was assessed.
resultsA total of 1157 episodes of suspected LONS in 706 neonates occurred. The nSOFA was significantly associated with 10-day mortality at various time points. The nSOFA score 6 hours after drawing a blood culture (T6) was associated with 10-day sepsis-related mortality (adjusted OR (aOR) 1.31; 95% CI (1.22 to 1.40; p<0.001)), in a model corrected for gestational age, sex, age at evaluation and gestational age-adjusted birth weight. The nSOFA burden scores were positively associated with the risk for ROP (aOR 1.24; 95% CI 1.09 to 1.41; p=0.001) and BPD (aOR 1.30; 95% CI 1.13 to 1.50; p<0.001).
conclusionOur findings show that the nSOFA score in preterm neonates suspected of LONS is associated with subsequent mortality, ROP and BPD. Incorporating nSOFA scores may help to identify sepsis survivors at the highest risk of adverse outcomes, who may require more intensive monitoring and adapted therapy.
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