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Early Prediction of Mortality after Birth Asphyxia with the nSOFA.

Authors :
Dathe AK
Stein A
Bruns N
Craciun ED
Tuda L
Bialas J
Brasseler M
Felderhoff-Mueser U
Huening BM
Source :
Journal of clinical medicine [J Clin Med] 2023 Jun 27; Vol. 12 (13). Date of Electronic Publication: 2023 Jun 27.
Publication Year :
2023

Abstract

(1) Birth asphyxia is a major cause of delivery room resuscitation. Subsequent organ failure and hypoxic-ischemic encephalopathy (HIE) account for 25% of all early postnatal deaths. The neonatal sequential organ failure assessment (nSOFA) considers platelet count and respiratory and cardiovascular dysfunction in neonates with sepsis. To evaluate whether nSOFA is also a useful predictor for in-hospital mortality in neonates (≥36 + 0 weeks of gestation (GA)) following asphyxia with HIE and therapeutic hypothermia (TH), (2) nSOFA was documented at ≤6 h of life. (3) A total of 65 infants fulfilled inclusion criteria for TH. All but one infant received cardiopulmonary resuscitation and/or respiratory support at birth. nSOFA was lower in survivors (median 0 [IQR 0-2]; n = 56, median GA 39 + 3, female n = 28 (50%)) than in non-survivors (median 10 [4-12], p < 0.001; n = 9, median GA 38 + 6, n = 4 (44.4%)). This was also observed for the respiratory ( p < 0.001), cardiovascular ( p < 0.001), and hematologic sub-scores ( p = 0.003). The odds ratio for mortality was 1.6 [95% CI = 1.2-2.1] per one-point increase in nSOFA. The optimal cut-off value of nSOFA to predict mortality was 3.5 (sensitivity 100.0%, specificity 83.9%). (4) Since early accurate prognosis following asphyxia with HIE and TH is essential to guide decision making, nSOFA (≤6 h of life) offers the possibility of identifying infants at risk of mortality.

Details

Language :
English
ISSN :
2077-0383
Volume :
12
Issue :
13
Database :
MEDLINE
Journal :
Journal of clinical medicine
Publication Type :
Academic Journal
Accession number :
37445355
Full Text :
https://doi.org/10.3390/jcm12134322