ASSESSMENT OF MODIFIED SICK NEONATAL SCORE FOR PROGNOSTICATION OF OUTCOMES IN NEONATES ADMITTED AT NICU CMH MULTAN

Abstract

Aim: The aim of this study was to evaluate the prognostic value of the Modified Sick Neonatal Score (MSNS) in predicting outcomes among neonates admitted to the Neonatal Intensive Care Unit (NICU) at CMH Multan. Methodology: This prospective validation study was conducted in the Department of Pediatrics, CMH Multan over a period of six months, from October 2025 to March 2026. Total 207 neonates aged 0–28 days admitted to the NICU were included using a non-probability consecutive sampling technique. The Modified Sick Neonatal Score was calculated at the time of admission using eight clinical parameters: respiratory rate, heart rate, axillary temperature, capillary refill time, random blood sugar, oxygen saturation, gestational age, and birth weight. The neonates were followed until the final outcome, which was recorded as discharge after recovery or death. Results: The mean gestational age of neonates was 34.5 ± 3.2 weeks, and the mean birth weight was 2200 ± 600 g. The mean MSNS score was 9.2 ± 3.4. Among the study participants, 58% were male and 42% were female. Most neonates (93%) were discharged after recovery, whereas 7% died during hospitalization. At a cutoff score of ≤10, MSNS showed 86% sensitivity, 55% specificity, 90% positive predictive value, 40% negative predictive value, and 82% diagnostic accuracy. ROC curve analysis showed an area under the curve of up to 0.81, indicating good predictive ability. Conclusion: The Modified Sick Neonatal Score is a simple and reliable bedside scoring system that can effectively predict neonatal outcomes and assist in early identification of high-risk neonates in NICU settings.