Clinical and laboratory factors that predict death in very low birth weight infants presenting with late-onset sepsis

Title

Clinical and laboratory factors that predict death in very low birth weight infants presenting with late-onset sepsis

Creator

Levit O; Bhandari V; Li Fang-Yong; Shabanova V; Gallagher PG; Bizzarro MJ

Publisher

The Pediatric Infectious Disease Journal

Date

2014

Subject

Female; Humans; infant; Male; retrospective studies; Intensive Care Units; Comorbidity; Risk Factors; Multivariate Analysis; Sepsis; Neonatal; Newborn; Connecticut; Very Low Birth Weight

Description

BACKGROUND: Late-onset sepsis (LOS) in very low birth weight (VLBW) infants is associated with significant morbidity and mortality. The ability to predict mortality in infants with LOS based on clinical and laboratory factors at presentation of illness remains limited. OBJECTIVES: To identify predictors of sepsis-associated mortality from a composite risk profile that includes demographic data, category of infecting organism, clinical and laboratory data at onset of illness. STUDY DESIGN: Data were collected from VLBW infants with at least 1 episode of LOS admitted to Yale Neonatal Intensive Care Unit from 1989 through 2007. Episodes were categorized as Gram-positive, Gram-negative or fungal. Multivariate logistic regression analysis was used to compare and contrast different types of infections and to assess independent risk factors for death. RESULTS: Four hundred twenty-four cases of LOS were identified in 424 VLBW infants. Of these, 262 (62%) were categorized as Gram-positive, 126 (30%) as Gram-negative and 36 (8%) as fungal. Multivariate analyses revealed that infants with Gram-positive infections had significantly lower odds of death compared to those with Gram-negative (adjusted odds ratio: 0.17; 95% confidence interval: 0.08-0.36) or fungal LOS (adjusted odds ratio: 0.22; 95% confidence interval: 0.07-0.64). Need for intubation, initiation of pressors, hypoglycemia and thrombocytopenia as presenting laboratory signs of infection and necrotizing enterocolitis were independent risk factors for sepsis-related death. CONCLUSIONS: We identified presenting clinical and laboratory factors, including category of infecting organism, which predict the increased risk of LOS-related death. This information can be useful in estimating prognosis shortly after the onset of disease.
2014-02

Rights

Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).

Type

Journal Article

Citation List Month

Backlog

Pages

143-146

Issue

2

Volume

33

Citation

Levit O; Bhandari V; Li Fang-Yong; Shabanova V; Gallagher PG; Bizzarro MJ, “Clinical and laboratory factors that predict death in very low birth weight infants presenting with late-onset sepsis,” Pediatric Palliative Care Library, accessed July 23, 2021, https://pedpalascnetlibrary.omeka.net/items/show/14982.

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