Sepsis in neonates with necrotizing enterocolitis: outcomes and predictive model

Area of Science:

• Neonatal Medicine
• Pediatric Surgery
• Infectious Diseases

Background:

• Sepsis is a serious complication following neonatal necrotizing enterocolitis (NEC).
• Effective tools for predicting sepsis risk in infants with NEC are currently lacking.
• Sepsis significantly increases the rates of surgical intervention and mortality in NEC patients.

Purpose of the Study:

• To investigate the impact of sepsis on outcomes in neonatal necrotizing enterocolitis.
• To develop and validate a predictive model for early sepsis identification in NEC patients.

Main Methods:

• Retrospective review of clinical data from 530 patients diagnosed with NEC.
• LASSO-Logistic regression analysis to identify independent predictors of sepsis.
• Development and validation of a Nomogram prediction model using training and testing sets.

Main Results:

• The overall incidence of sepsis in the NEC cohort was 56.2%.
• Independent predictors for sepsis included gestational age, age at NEC onset, C-reactive protein, ventilator support, and hypoproteinemia.
• The developed Nomogram model demonstrated high discriminative performance (AUCs of 0.937 and 0.917 for training and testing sets, respectively) and good calibration.

Conclusions:

• The Nomogram model effectively predicts sepsis risk in infants with NEC.
• This tool aids clinicians in enhancing risk assessment and implementing early preventive interventions.
• Early sepsis prediction can potentially improve outcomes for infants with neonatal necrotizing enterocolitis.