Volume 11, Issue 1 (2025)
CJP 2025, 11(1): e11 |
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Kousika K, Devimeenakshi K. Serial Modified Sick Neonatal Score as a tool for predicting neonatal mortality: an observational study at a single center. CJP 2025; 11 (1)
URL: http://caspianjp.ir/article-1-254-en.html
URL: http://caspianjp.ir/article-1-254-en.html
MD Pediatrics, Professor of Pediatrics, Department of Pediatrics, Kilpauk Medical College, India & Professor,Departmentof pediatrics, Kilpauk medical college,Chennai , drdevi_1804@yahoo.in
Abstract: (34 Views)
Background and Objective: Early detection of disease in newborns through the use of disease scores can improve outcomes. Currently used scoring systems require arterial blood gas analysis, which may not be available in resource-limited settings. The aim of this study was to determine whether cost-effective alternatives, such as the Modified Sick Neonatal Score (MSNS), can predict neonatal mortality.
Methods: This cross-sectional study was conducted on the neonates who required admission to the neonatal intensive care unit (NICU) of a college Medical hospital from February 2021 to September 2021. MSNS was done on admission, daily for 7 days and during the period of clinical deterioration. The mean (standard deviation (SD)) values at admission and the lowest recorded value were compared with the outcome. A receiver-operating characteristic curve (ROC) analysis was performed to determine the optimal cut-off value for predicting mortality.
Findings: The mortality rate was 4.58%. The mean (SD) MSNS at admission of deceased neonates [9.04(1.612)] was significantly lower than that of improved neonates [14.68(1.610)]. The mean (SD) lowest MSNS for deceased neonates [6.23(1.177)] was significantly lower than that for improved neonates [14.5(1.893)]. The area under the curve (AUC) for admission score was 0.958, and a score of 12 predicted mortality with a sensitivity of 91% and a specificity of 95.2%. The AUC for the lowest score was 0.995, and a score of 9 had a sensitivity of 94% and a specificity of 99% for predicting mortality.
Conclusion: Serial MSNS is a good predictor of mortality, and low scores on admission and the lowest score during hospitalization correlated well with poor outcomes.
Methods: This cross-sectional study was conducted on the neonates who required admission to the neonatal intensive care unit (NICU) of a college Medical hospital from February 2021 to September 2021. MSNS was done on admission, daily for 7 days and during the period of clinical deterioration. The mean (standard deviation (SD)) values at admission and the lowest recorded value were compared with the outcome. A receiver-operating characteristic curve (ROC) analysis was performed to determine the optimal cut-off value for predicting mortality.
Findings: The mortality rate was 4.58%. The mean (SD) MSNS at admission of deceased neonates [9.04(1.612)] was significantly lower than that of improved neonates [14.68(1.610)]. The mean (SD) lowest MSNS for deceased neonates [6.23(1.177)] was significantly lower than that for improved neonates [14.5(1.893)]. The area under the curve (AUC) for admission score was 0.958, and a score of 12 predicted mortality with a sensitivity of 91% and a specificity of 95.2%. The AUC for the lowest score was 0.995, and a score of 9 had a sensitivity of 94% and a specificity of 99% for predicting mortality.
Conclusion: Serial MSNS is a good predictor of mortality, and low scores on admission and the lowest score during hospitalization correlated well with poor outcomes.
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