Early Prediction of Mortality after Birth Asphyxia with the nSOFA
(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 d...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-06-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/13/4322 |
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| author | Anne-Kathrin Dathe Anja Stein Nora Bruns Elena-Diana Craciun Laura Tuda Johanna Bialas Maire Brasseler Ursula Felderhoff-Mueser Britta M. Huening |
| author_facet | Anne-Kathrin Dathe Anja Stein Nora Bruns Elena-Diana Craciun Laura Tuda Johanna Bialas Maire Brasseler Ursula Felderhoff-Mueser Britta M. Huening |
| author_sort | Anne-Kathrin Dathe |
| collection | DOAJ |
| description | (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]; <i>n</i> = 56, median GA 39 + 3, female <i>n</i> = 28 (50%)) than in non-survivors (median 10 [4–12], <i>p</i> < 0.001; <i>n</i> = 9, median GA 38 + 6, <i>n</i> = 4 (44.4%)). This was also observed for the respiratory (<i>p</i> < 0.001), cardiovascular (<i>p</i> < 0.001), and hematologic sub-scores (<i>p</i> = 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. |
| first_indexed | 2024-03-11T01:37:35Z |
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| id | doaj.art-de87032140374842a316b836a308fb98 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T01:37:35Z |
| publishDate | 2023-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-de87032140374842a316b836a308fb982023-11-18T16:52:11ZengMDPI AGJournal of Clinical Medicine2077-03832023-06-011213432210.3390/jcm12134322Early Prediction of Mortality after Birth Asphyxia with the nSOFAAnne-Kathrin Dathe0Anja Stein1Nora Bruns2Elena-Diana Craciun3Laura Tuda4Johanna Bialas5Maire Brasseler6Ursula Felderhoff-Mueser7Britta M. Huening8Neonatology, Paediatric Intensive Care and Paediatric Neurology, Department of Paediatrics I, University Hospital Essen, University of Duisburg-Essen, 45122 Essen, GermanyNeonatology, Paediatric Intensive Care and Paediatric Neurology, Department of Paediatrics I, University Hospital Essen, University of Duisburg-Essen, 45122 Essen, GermanyNeonatology, Paediatric Intensive Care and Paediatric Neurology, Department of Paediatrics I, University Hospital Essen, University of Duisburg-Essen, 45122 Essen, GermanyNeonatology, Paediatric Intensive Care and Paediatric Neurology, Department of Paediatrics I, University Hospital Essen, University of Duisburg-Essen, 45122 Essen, GermanyNeonatology, Paediatric Intensive Care and Paediatric Neurology, Department of Paediatrics I, University Hospital Essen, University of Duisburg-Essen, 45122 Essen, GermanyNeonatology, Paediatric Intensive Care and Paediatric Neurology, Department of Paediatrics I, University Hospital Essen, University of Duisburg-Essen, 45122 Essen, GermanyNeonatology, Paediatric Intensive Care and Paediatric Neurology, Department of Paediatrics I, University Hospital Essen, University of Duisburg-Essen, 45122 Essen, GermanyNeonatology, Paediatric Intensive Care and Paediatric Neurology, Department of Paediatrics I, University Hospital Essen, University of Duisburg-Essen, 45122 Essen, GermanyNeonatology, Paediatric Intensive Care and Paediatric Neurology, Department of Paediatrics I, University Hospital Essen, University of Duisburg-Essen, 45122 Essen, Germany(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]; <i>n</i> = 56, median GA 39 + 3, female <i>n</i> = 28 (50%)) than in non-survivors (median 10 [4–12], <i>p</i> < 0.001; <i>n</i> = 9, median GA 38 + 6, <i>n</i> = 4 (44.4%)). This was also observed for the respiratory (<i>p</i> < 0.001), cardiovascular (<i>p</i> < 0.001), and hematologic sub-scores (<i>p</i> = 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.https://www.mdpi.com/2077-0383/12/13/4322birth asphyxianSOFAoutcome predictionneonatehypoxic–ischemic encephalopathy (HIE)therapeutic hypothermia |
| spellingShingle | Anne-Kathrin Dathe Anja Stein Nora Bruns Elena-Diana Craciun Laura Tuda Johanna Bialas Maire Brasseler Ursula Felderhoff-Mueser Britta M. Huening Early Prediction of Mortality after Birth Asphyxia with the nSOFA Journal of Clinical Medicine birth asphyxia nSOFA outcome prediction neonate hypoxic–ischemic encephalopathy (HIE) therapeutic hypothermia |
| title | Early Prediction of Mortality after Birth Asphyxia with the nSOFA |
| title_full | Early Prediction of Mortality after Birth Asphyxia with the nSOFA |
| title_fullStr | Early Prediction of Mortality after Birth Asphyxia with the nSOFA |
| title_full_unstemmed | Early Prediction of Mortality after Birth Asphyxia with the nSOFA |
| title_short | Early Prediction of Mortality after Birth Asphyxia with the nSOFA |
| title_sort | early prediction of mortality after birth asphyxia with the nsofa |
| topic | birth asphyxia nSOFA outcome prediction neonate hypoxic–ischemic encephalopathy (HIE) therapeutic hypothermia |
| url | https://www.mdpi.com/2077-0383/12/13/4322 |
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