The Neonatal Scale of Multiple Organ Failure (neoSMOF)

Description

Introduction. Neonatal sepsis is a leading cause of morbidity and mortality in newborns, yet a comprehensive multiple organ dysfunction scale for this age group is lacking. The existing nSOFA scale assesses only three organ systems and has other limitations. Objectives. To develop a new neonatal multiple organ dysfunction scale and compare its predictive performance for mortality with the nSOFA scale in neonates with infection. Material and Methods. A retrospective single-center study of 140 newborns with infection receiving antimicrobial therapy for ≥5 days. Peak and initial (early and late-onset infections) scores were compared. The primary endpoint was in-hospital mortality. Results. Overall mortality was 8.6%. The new scale showed excellent discrimination for mortality (AUC ROC 0.98), comparable to nSOFA (0.94; p>0.05). In early-onset infections, both scales performed similarly (AUC 0.84–0.85). In late-onset infections, the new scale significantly predicted mortality (p=0.037; AUC 0.80), whereas nSOFA did not (p = 0.256; AUC 0.69). Conclusions. The proposed neonatal MODS scale is an effective predictor of mortality in neonatal infections, comparable to nSOFA, with potential superiority in late-onset infections.

Institutions

• Ural State Medical University

  Sverdlovsk Oblast, Yekaterinburg

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