Background Modified Sick Neonatal Score (MSNS) is a modification of the Sick Neonatal Score (SNS) by adding perinatal factors such as birth weight and gestational age to the scoring. A significantly higher sensitivity and specificity were obtained by adding the above parameters to SNS. The parameters in MSNS were simple and easy to score, but the scoring was done only once, and the utility of the score to assess the response to treatment was not analysed. In this study, we aimed to determine the role of MSNS as a prognostic indicator in the neonatal intensive care unit (NICU) and to study the correlation of the change in the MSNS (Delta-MSNS) 24 hours after admission with the outcomes and as a measure of response to treatment. Methodology A cross-sectional study was conducted for six months on all neonates admitted to the NICU during the study period. All babies were scored using MSNS containing eight basic clinical parameters, namely, respiratory rate, heart rate, axillary temperature, peripheral capillary refill time, random blood sugar, oxygen saturation, gestational age, and birth weight. Scoring by MSNS was done on the following two occasions: first score at admission, and second score 24 hours later. A change in the score during the first 24 hours of NICU stay (Delta-MSNS) was analysed for babies with an initial score of less than or equal to 12. All babies were followed up for analysis of outcomes, and outcomes were documented as discharge from the hospital or death. Length of hospital stay was documented for the babies that were discharged. Statistical analysis was done using the software RStudio v1.1.456. Kruskal-Wallis rank sum test was used to compare individual parameters of the score as well as the mean score between the expired and discharged groups. Spearman rank-order correlation coefficient was used to correlate the scores with length of hospital stay. Results A total of 248 neonates were considered for inclusion in the study. The mean score at admission was 7.94 (SD = 1.89) in the expired group and 14.46 (SD = 1.84) in the discharged group. The p-value for each of these was <0.001. Using MSNS as a test variable, a receiver operating characteristic (ROC) curve was generated, and as measured by the area under the curve was 0.98. A cut-off score of 10 was obtained that had a sensitivity of 88.24%, specificity of 95.2%, positive predictive value of 57.69%, and negative predictive value of 99%. A significant negative correlation was observed with a Spearman correlation coefficient of -0.67 when the initial MSNS was correlated with length of hospital stay in patients who were discharged. A significant negative correlation with a coefficient of -0.39 and p-value of 0.017 was determined when delta MSNS score was correlated with the discharged babies who had an initial score of less than 12. Conclusions MSNS is an easy-to-use bedside scoring system that requires minimal training and no invasive procedures. It has shown a h...
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.