Predictors of Death in Patients with Neonatal Sepsis in a Peruvian Hospital

Abstract

Reducing neonatal mortality is a global challenge. This study’s objective was to determine the predictors of mortality in patients with neonatal sepsis. The study was a retrospective cohort study in a Peruvian hospital from January 2014 to April 2022. Neonates diagnosed with sepsis were included. To find predictors of mortality, we used Cox proportional regression models. We evaluated 288 neonates with sepsis; the median birth weight and hospitalization time were 3270 g and seven days, respectively. During follow-up, 18.4% did not survive, and the most common complications were jaundice (35.42%), respiratory distress syndrome (29.51%), and septic shock (12.5%). The most isolated bacteria were Klebsiella pneumoniae. The risk factors associated with higher mortality were prematurity (aHR = 13.92; 95% CI: 1.71–113.51), platelets <150,000 (aHR = 3.64; 1.22–10.88), creatinine greater than 1.10 (aHR = 3.03; 1.09–8.45), septic shock (aHR = 4.41; 2.23–8.74), and admission to IMV (aHR = 5.61; 1.86–16.88), On the other hand, breastfeeding was associated with a lower risk of death (aHR = 0.25; 0.13–0.48). In conclusion, we report a high incidence of death and identify clinical (prematurity, septic shock, admission to IMV) and laboratory characteristics (elevated creatinine and thrombocytopenia) associated with higher mortality in patients with neonatal sepsis. Breastfeeding was a factor associated with survival in these patients.

Hierarchical Predictors of Mortality in Neonatal Sepsis at Jimma Medical Center, Ethiopia: A Case–Control Study

“…Low-birth-weight infants are more than two-and-a-half times more likely to die from sepsis compared to normal-weight neonates and contribute to 6.3% of avoidable mortality. This finding coincides with previous studies of Asia, 14 Peru, 37 Serbia, 15 Nigeria, 16 and India 17 and northwest Ethiopia, 25 and indicates that interventions to address the specific challenges faced by low-birth-weight neonates could potentially avoid approximately 6.3% of neonatal mortality from sepsis. Studies have implicated this finding in several countries, including Ethiopia.…”

“…In other words, approximately 7.2% of neonatal mortality cases caused by sepsis could be attributed to delayed initiation of breastfeeding. This finding is commensurate with several previous studies conducted in Peru, 37 northwest Ethiopia, 25 and public hospitals in Southern Ethiopia 40 and suggests that promoting early breastfeeding initiation could potentially reduce the incidence of neonatal mortality from sepsis by addressing this particular risk factor. Researchers have delved into several reasons why breastfeeding can have these positive effects, including the presence of antibodies, immune factors, enhanced gut integrity, and nutritional balance.…”

Microbial Pattern of Neonatal Sepsis in the Neonatal Intensive Care Unit of dr. Ramelan Navy Central Hospital

“…Neonates with sepsis require intensive care in the NICU due to respiratory distress and hemodynamic instability [ 2 ]. A retrospective cohort study by Vizcarra-Jiménez et al stated that 18.4% of neonates died while being treated in the NICU [ 3 ]. Survival rates for neonatal sepsis patients requiring intensive care are reported to be low, according to a prospective observational study by Flannery et al [ 4 ].…”

The Relationship between APGAR Score and Delivery Mode with Neonatal Sepsis in Ulin Regional Hospital Banjarmasin

“…Neonatal sepsis is the most common cause of child mortality worldwide, affecting up to 3 million neonates each year. Deaths from neonatal sepsis are more common in developing countries with lower middle incomes (1).…”