Key result
The modified NEOMOD score demonstrated the best prediction for 30-day mortality after neonatal cardiac surgery, reaching its peak performance on day 2 (AUC 0.824; 95% CI 0.75-0.89).
Why the study?
Infants undergoing cardiac surgery frequently develop complications advancing to multiple organ failure and mortality, warranting evaluation of multiple organ dysfunction scores to predict postoperative mortality.
Which multiple organ dysfunction scoring system (NEOMOD, modified NEOMOD, or PELOD-2) best predicts postoperative 30-day mortality in neonates undergoing cardiac surgery?
Cohort (n=138)
No
Which multiple organ dysfunction scoring system (NEOMOD, modified NEOMOD, or PELOD-2) best predicts postoperative 30-day mortality in neonates undergoing cardiac surgery?
Effect estimate: AUC 0.824 (95% CI 0.75-0.89)
The modified NEOMOD score is an effective tool for predicting 30-day mortality in neonates following cardiac surgery for congenital heart disease.
Day-2 modified NEOMOD best predicted 30-day mortality; leaves open whether scores should guide care in neonatal cardiac surgery.
Infants who undergo cardiac surgery frequently have complications that may advance to multiple organ failure and result in mortality. This study aims to compare three different multiple organ dysfunction scoring systems: the Neonatal Multiple Organ Dysfunction (NEOMOD) score, the modified NEOMOD score, and the Pediatric Logistic Organ Dysfunction-2 (PELOD-2) score in predicting postoperative 30-day mortality in neonates undergoing cardiac surgery. This retrospective cohort study was conducted between January 2019 and February 2021 in a single unit on neonates operated on due to congenital heart disease in the first 28 days of life. Patients who underwent off-pump surgeries were excluded from the study. The NEOMOD, modified NEOMOD, and PELOD-2 scores were calculated for each of the first 3 days following surgery. A total of 138 patients were included. All scores had satisfactory goodness-of-fit and at least good discriminative ability on each day. The modified NEOMOD score consistently demonstrated the best prediction among these three scores after the first day, reaching its peak performance on day 2 (area under curve: 0.824, CI: 0.75-0.89). Our findings suggest that NEOMOD and modified NEOMOD scores in the first 72 h could potentially serve as a predictor of mortality in this population.
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Bezirganoğlu et al. (2023) conducted a cohort in Congenital heart disease requiring neonatal cardiac surgery (n=138). Multiple organ dysfunction scoring systems (NEOMOD, modified NEOMOD, PELOD-2) was evaluated on postoperative 30-day mortality (AUC 0.824, 95% CI 0.75-0.89). The modified NEOMOD score demonstrated the best prediction for 30-day mortality after neonatal cardiac surgery, reaching its peak performance on day 2 (AUC 0.824; 95% CI 0.75-0.89).
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