Modified Sick Neonatal Score and Delta: Modified Sick Neonatal Scores As Prognostic Indicators in Neonatal Intensive...

Area of Science:

• Neonatal Intensive Care
• Pediatric Medicine
• Clinical Scoring Systems

Background:

• The Modified Sick Neonatal Score (MSNS) enhances the Sick Neonatal Score (SNS) by incorporating perinatal factors like birth weight and gestational age.
• While MSNS offers improved sensitivity and specificity, its utility in assessing treatment response has not been analyzed.

Purpose of the Study:

• To evaluate the role of MSNS as a prognostic indicator in the Neonatal Intensive Care Unit (NICU).
• To assess the correlation of the change in MSNS (Delta-MSNS) after 24 hours with patient outcomes and treatment response.

Main Methods:

• A cross-sectional study involving 248 neonates admitted to the NICU over six months.
• MSNS was calculated at admission and 24 hours later; Delta-MSNS was analyzed for neonates with an initial score ≤12.
• Statistical analysis included Kruskal-Wallis and Spearman correlation tests.

Main Results:

• MSNS demonstrated high accuracy in predicting mortality (Area Under Curve = 0.98) with a cutoff score of 10 (sensitivity 88.24%, specificity 95.2%).
• Initial MSNS showed a significant negative correlation with length of hospital stay (r = -0.67).
• Delta-MSNS correlated significantly with outcomes in discharged neonates with an initial score <12 (r = -0.39, p=0.017).

Conclusions:

• MSNS is a simple, non-invasive bedside tool for assessing neonatal illness severity, requiring minimal training.
• The score effectively predicts mortality and length of hospital stay.
• Delta-MSNS calculation provides a valuable measure of treatment response and prognosis.