Short- and long-term clinical outcomes in newborns with a septic phenotype of multiple organ dysfunction syndrome

BACKGROUND: A current priority in addressing multiple organ dysfunction syndrome in adults, children, and newborns is the identification of syndrome phenotypes and the development of individualized treatment and rehabilitation measures. The septic phenotype of multiple organ dysfunction syndrome is associated with high morbidity, mortality, and poor long-term health outcomes; however, in neonatal practice this phenotype remains insufficiently studied, which determined the aim of the present study.

AIM: This study aimed to conduct a comparative analysis of short-term in-hospital and long-term outcomes in newborns with septic versus hypoxic phenotypes of multiple organ dysfunction syndrome.

METHODS: A retrospective study was performed including 128 newborns with multiple organ dysfunction syndrome, that were divided into two groups: group A (n = 67) with the septic phenotype and group B (n = 61) with the hypoxic phenotype. Outcomes were assessed at 1 month and 1 year of life and included treatment duration, complications, and physical as well as neuropsychological development. Statistical analysis was performed using nonparametric tests.

RESULTS: Newborns with the septic phenotype of multiple organ dysfunction syndrome demonstrated a significantly more severe disease course, including longer duration of stay in the neonatal intensive care unit (22 vs 10 days, p = 0.001), longer duration (9 vs 5 days, p = 0.04), and a higher rate of progression to persistent multiple organ dysfunction syndrome (20.9% vs 3.3%, p = 0.001). At 1 month of age, lesions of the central nervous system, abdominal organs, cardiovascular system, and hearing disorders were remarkably more frequent in this group. By 1 year of age, the septic phenotype group continued to show a higher prevalence of neurological complications, including motor impairment syndrome (43.2% vs 19.7%, p = 0.008), hypertensive–hydrocephalic syndrome (26.9% vs 8.2%, p = 0.005), and cardiovascular system involvement. No significant differences were found between groups in physical or neuropsychological development indices.

CONCLUSION: The septic phenotype of multiple organ dysfunction syndrome in newborns is associated with more severe short- and long-term outcomes compared with the hypoxic phenotype, predominantly manifesting as involvement of the central nervous and cardiovascular systems. These findings indicate the need to develop individualized treatment and rehabilitation approaches for this patient population.