Development and validation of a model for prediction of septic shock in neonates with sepsis.

Abstract

This study aimed to develop and validate a model for prediction of septic shock in neonates with sepsis. This retrospective study included early-onset septic neonates in the Renmin Hospital of Wuhan University between January 2017 and June 2021. The neonates were divided into the training set and the validation set in a ratio of 7:3, and further categorized into septic shock group and none-shock group according to presence or absence of shock symptoms. A total of 406 septic neonates were enrolled, including 217 in septic shock group. Sex (odds ratio [OR] = 0.092, 95% confidence interval [CI]: 0.012 to 0.683, P = 0.020), C-reactive protein at 6 h (OR = 8.475, 95% CI: 3.154 to 22.774, P < 0.001), serum amyloid A at 6 h (OR = 1.179, 95% CI: 1.094 to 1.269, P < 0.01), white blood cells at 6 h (OR = 0.173, 95% CI: 0.092 to 0.326, P < 0.001), platelets at 6 h (OR = 0.985, 95% CI: 0.975 to 0.995, P < 0.001), and Ca2+ at 6 h (OR = 1.44x1011, 95% CI: 2.70 x106 to 7.70 x1015, P < 0.001) were identified as independent risk factors for septic shock and were further included in the nomogram. The area under the receiver operator characteristic curve were 0.873 and 0.920 in training and validation sets, respectively. A predictive model for early diagnosis of septic shock in neonates was developed and initially validated in this study, allowing for timely intervention.