Comparing the prognostic accuracy of the Neonatal Sequential organ failure assessment (nSOFA) score and the Score for Neonatal Acute Physiology Perinatal Extension-II (SNAPPE-II) score in neonates with sepsis.

Abstract Objective: This study compares the prognostic accuracy of the Neonatal Sequential Organ Failure Assessment (nSOFA) score and the Score for Neonatal Acute Physiology Perinatal Extension-II (SNAPPE-II) in predicting mortality among neonates with sepsis. Methods: A retrospective cohort analysis was conducted on 175 septic neonates admitted to the NICU. nSOFA and SNAPPE-II scores were calculated and analyzed using logistic regression and AUROC curves. Results: Both scores were significantly higher among non-survivors (p < 0.001). SNAPPE-II demonstrated a slightly superior predictive ability (AUC: 0.893) compared to nSOFA (AUC: 0.861). A moderate positive correlation (r = 0.514, p < 0.001) was observed between the two scores. Logistic regression confirmed both as independent predictors of mortality. Conclusion: While SNAPPE-II marginally outperformed nSOFA in predictive accuracy, nSOFA’s simplicity and real-time applicability render it highly valuable, particularly in resource-limited settings. Both tools offer robust risk stratification and can guide early, targeted intervention in neonatal sepsis.