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Updated: May 25, 2026
A Neonatal Imaging Model of Gram-Negative Bacterial Sepsis
Published on: August 12, 2020
Development of a Simple Clinical Risk Score for Mortality Prediction in Neonatal Gram-Negative Sepsis
Akanksha Verma1, Richa Sinha2,3, Surabhi Periwal4,5
1Department of Neonatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, 226014, India. Akanksha.ve@gmail.com.
Objectives:
To identify clinical and laboratory predictors of mortality and develop a simple bedside risk score for neonates with Gram-negative sepsis.
Methods:
A total of 50 neonates satisfying as per the inclusion criteria during the reference period were included in the study. Independent predictors of mortality were identified using univariable and multivariable binary logistic regression and Least Absolute Shrinkage and Selection Operator (LASSO) regression, and were used to develop a Neonatal Risk Scoring System (NRSS).
Results:
Mortality occurred in 38% (19/50). On multivariable analysis, necrotizing enterocolitis (NEC) ≥ Stage II (OR 45.24, p = 0.003), refractory shock (OR 6.54, p = 0.047), and leukopenia (OR 20.01, p = 0.018) independently predicted mortality. The NRSS (weights 8, 4, and 6, respectively) showed excellent discrimination (AUC > 0.9). Mean NRSS was higher in non-survivors (9.47 ± 5.37) vs. survivors (1.74 ± 2.35, p < 0.001). A cut-off ≥ 7 predicted mortality with 73.7% sensitivity and 96.8% specificity.
Conclusions:
NEC ≥ Stage II, refractory shock, and leukopenia independently predict mortality. The NRSS provides a simple, reliable tool for early risk stratification.
