Neonatal Sequential Organ Failure Assessment Score to Predict Mortality in Neonatal Intensive Care Unit at Tertiary Care Center

Background: The Neonatal Sequential Organ Failure Assessment (nSOFA) score is a tool used to evaluate degree of organ dysfunction in critically ill neonates admitted to neonatal intensive care units (NICUs). The nSOFA score is based on respiratory, cardiac and hematological parameters (total score ranges from 0 to 15). This study aims to evaluate the applicability of nSOFA score to predict neonatal mortality in NICU of Patan Hospital. Methods: This prospective observational study was conducted at the NICU of Patan Hospital, Lalitpur, Nepal from May 2023 to November 2024. The parameters of nSOFA score were recorded at admission and between 48-72 hours of admission. Data were analyzed using EPI-INFO and Easy R software. Results: Among 134 neonates, 105 (78%) survived, and 29 (22%) did not. At admission, a nSOFA score ≥4 had a sensitivity of 69%, specificity of 91.4%, positive predictive value (PPV) of 69% and negative predictive value (NPV) of 91.4% for predicting mortality. At 48-72 hours, a cutoff score of ≥5 showed a sensitivity of 75.7%, specificity of 99%, PPV of 96.6% and NPV of 91.4%. Conclusion: The nSOFA score is a important tool for predicting neonatal mortality in NICUs and can be used to guide clinical decision-making.