Affiliations: University Children's Hospital, Greifswald,
Germany | Children's Hospital St Marien, Landshut, Germany | Department of Pediatrics, Neonatal-Perinatal Medicine,
University of Oklahoma, OK, USA | Inselspital Bern, Bern, Switzerland | Helmholtz Center, HZM-Haematologikum, Munich,
Germany | Department of Pediatric Cardiology, University
Children's Hospital, Innsbruck, Austria
Abstract: Objective: To establish a score to predict late-onset sepsis in very
low birth weight infants. Study Design: Two successive prospective multi
center studies in very low birth weight infants were used: infants in the first
served as calculation cohort, those in the second as validation cohort. Infants
were divided into a sepsis group, a non-sepsis group, and an undetermined group
by predefined criteria partially based on the sepsis definition by the Robert
Koch institute. In the first study 39 parameters recorded daily were compared
in the sepsis and the non-sepsis group between Day -3 and Day 0 of sepsis. The
score was created combining those parameters with the highest area under the
ROC curve. Results: A score was generated consisting of five clinical and
laboratory categories: peripheral circulation, respiration, gastrointestinal
tract, general laboratory findings and infection-specific laboratory findings.
Sepsis was defined as pathological findings in at least 2 out of these 5
categories. This scoring system reached a sensitivity of 84.0% and a
specificity of 91.7% (PPV 87.5% and NPV 89.2%) in discriminating the
sepsis group from the non-sepsis group in the validation cohort. Conclusion: We created a score for early diagnosis of late-onset sepsis in
very low birth weight infants. The score may be of value when comparing infants
with sepsis in multi center studies.
Keywords: Late onset neonatal sepsis, NICU, sepsis score, very low birth weight
