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journal article Open Access Sep 22, 2021

Multi‐organ dysfunction scoring in neonatal encephalopathy (MODE Score) and neurodevelopmental outcomes

Deirdre Una Sweetman Tammy Strickland Eman Isweisi ORCID Lynne Kelly ORCID Marie Therese Slevin ORCID Veronica Donoghue Judith Meehan Geraldine Boylan John Finbar Anthony Murphy Afif El‐Khuffash Eleanor J. Molloy
Acta Paediatrica Vol. 111 No. 1 pp. 93-98 · Wiley
View at Publisher Save 10.1111/apa.16111
Abstract
AbstractAimNeonatal encephalopathy (NE) is associated with an increased risk of multi‐organ injury. The lack of standardised definitions for multi‐organ dysfunction in NE hinders accurate quantification of these complications.MethodsA simple multi‐organ dysfunction in neonatal encephalopathy scoring (MODE) system was created to include the cardiovascular, respiratory, gastrointestinal, haematological and neurological systems with a maximum score of 15. The MODE score was then compared with the grade of NE, Bayley Scales of Infant Development (Bayley‐III) at 2 years of age and mortality. The Bayley score was used as it gave an objective score making it easier to compare the MODE score. Bayley score of <90 and/or abnormal MRI as an adverse outcome.ResultsInfants with perinatal asphyxia (PA:n = 85) were prospectively enrolled (PA only n = 9; NE I = 23; NE II = 42; NE III = 11). Infants with higher MODE scores were significantly more likely to have moderate/severe NE (NE II/III: median scores (IQR) 7(5–10) versus mild NE 2 (1–3); p‐value < 0.001) The MODE score was highly predictive of mortality (AUC 0.96, p‐value = 0.002). Infants who had an abnormal neurological examination at discharge or abnormal Bayley‐III scores had significantly higher MODE scores (p‐value = 0.001).ConclusionQuantifying multi‐organ injury is important to plan optimal early management and long‐term follow‐up. Additional use of clinical biomarkers may be useful as surrogate endpoints in future clinical trials and link to multi‐organ longer‐term developmental follow‐up.
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Metrics
15
Citations
35
References
Details
Published
Sep 22, 2021
Vol/Issue
111(1)
Pages
93-98
License
View
Authors
D
Deirdre Una Sweetman

Neonatology National Maternity Hospital Dublin Ireland; National Children’s Research Centre Dublin Ireland

T
Tammy Strickland

Paediatrics Trinity College Dublin Trinity Research in Childhood Centre (TRICC) & Children’s Hospital Ireland (CHI) at Tallaght Dublin Ireland

E
Eman Isweisi

National Children’s Research Centre Dublin Ireland; Paediatrics Trinity College Dublin Trinity Research in Childhood Centre (TRICC) & Children’s Hospital Ireland (CHI) at Tallaght Dublin Ireland

L
Lynne Kelly

Paediatrics Trinity College Dublin Trinity Research in Childhood Centre (TRICC) & Children’s Hospital Ireland (CHI) at Tallaght Dublin Ireland

M
Marie Therese Slevin

Neonatology National Maternity Hospital Dublin Ireland

V
Veronica Donoghue

Neonatology National Maternity Hospital Dublin Ireland

J
Judith Meehan

Paediatrics Trinity College Dublin Trinity Research in Childhood Centre (TRICC) & Children’s Hospital Ireland (CHI) at Tallaght Dublin Ireland

G
Geraldine Boylan

INFANT Research Centre University College Cork Cork Ireland

J
John Finbar Anthony Murphy

Neonatology National Maternity Hospital Dublin Ireland; School of Medicine The Royal College of Surgeons in Ireland Dublin Ireland

A
Afif El‐Khuffash

School of Medicine The Royal College of Surgeons in Ireland Dublin Ireland; Neonatology The Rotunda Hospital Dublin Ireland

E
Eleanor J. Molloy

National Children’s Research Centre Dublin Ireland; Paediatrics Trinity College Dublin Trinity Research in Childhood Centre (TRICC) & Children’s Hospital Ireland (CHI) at Tallaght Dublin Ireland; School of Medicine The Royal College of Surgeons in Ireland Dublin Ireland; Neonatology CHI at Crumlin Dublin Ireland; Neonatology Coombe Women’s and Infants University Hospital Dublin Ireland

Cite This Article
Deirdre Una Sweetman, Tammy Strickland, Eman Isweisi, et al. (2021). Multi‐organ dysfunction scoring in neonatal encephalopathy (MODE Score) and neurodevelopmental outcomes. Acta Paediatrica, 111(1), 93-98. https://doi.org/10.1111/apa.16111
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