EVALUATION OF MODIFIED SICK NEONATAL SCORE (MSNS) TO DETERMINE OUTCOME IN PRETERM BABIES ADMITTED TO A TERTIARY CARE NEONATAL INTENSIVE CARE UNIT

Background: Various neonatal scoring systems have been developed and can be used to either estimate the severity of an illness or disease progression, such as the Clinical Risk Index for Babies (CRIB II) score and the Sick Neonate Score (SNS) score. This study was done to evaluate the applicability of modified sick neonatal score (MSNS), which is a simple scoring system that can be used to determine outcome in neonates in the resource-restricted settings, exclusively in preterm neonates. Methods: This was a hospital based descriptive study, including a total of 45 preterm newborns admitted to the NICU. Modified Sick Neonatal Score was evaluated immediately after arrival in the NICU. All newborns were managed as per standard NICU protocols and were followed up until discharge or expiry. The score and its individual parameters were then correlated with the outcome (expired/discharged). Results: Out of the 45 preterm neonates admitted to the NICU, 4 expired, and the rest were discharged. The mean score in the expired neonates was 8.2 and a cut-off score of 9.5 had a sensitivity of 100% (95% CI 39.76%-100.00%) and specificity of 90.24% (95% CI 76.87%-97.28%). The quality of respiratory effort was found to be the major determinant of mortality in the studied population, with a p-value = 0.001. Heart rate, axillary temperature and oxygen saturation also correlated well with the outcome, with p-values <0.05. Conclusion: There was a direct correlation between the Modified Sick Neonatal Score and poor outcome in preterm neonates. A cut-off score of 9.5 could be used to predict mortality in this population.