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Evaluation of risk factors for fatal neonatal sepsis
N B Mathur1, A Singh, V K Sharma
1Department of Pediatrics, Maulana Azad Medical College, New Delhi.
Objective:
To evaluate risk factors for fatal neonatal sepsis.
Design:
Prospective study.
Setting:
Referral neonatal unit of a teaching hospital.
Subjects:
171 neonates admitted with sepsis.
Methods:
Clinical examination and investigations on the day of admission were recorded and the neonates followed up to determine the final outcome.
Results:
The overall fatality was 48.5%. In the univariate analysis, the factors significantly associated with death were weight, gestational age, age at onset of sepsis, hypothermia, requirement of IPPV, presence of refractory septic shock, neutropenia, metabolic acidosis and raised prothrombin time. However, in the multivariate analysis, only neutropenia, metabolic acidosis, increased prothrombin time and refractory septic shock retained their significance. The adjusted odd's ratio (95% confidence interval) were 0.095 (0.04 = 0.22), 1.14 (1.04-1.25), 1.04 (1.002-1.08) and 11.82 (5.47-69.40), respectively.
Conclusion:
Even in a setting with high fatality rates, high risk of mortality in neonatal sepsis can be identified and targeted for intensive intervention.