Abstract
BackgroundPrediction modelling can greatly assist the health-care professionals in the management of diseases, thus sparking interest in neonatal sepsis diagnosis. The main objective of the study was to provide a complete picture of performance of prediction models for early detection of neonatal sepsis.MethodsPubMed, Scopus, CINAHL databases were searched and articles which used various prediction modelling measures for the early detection of neonatal sepsis were comprehended. Data extraction was carried out based on Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies checklist. Extricate data consisted of objective, study design, patient characteristics, type of statistical model, predictors, outcome, sample size and location. Prediction model Risk of Bias Assessment Tool was applied to gauge the risk of bias of the articles.ResultsAn aggregate of ten studies were included in the review among which eight studies had applied logistic regression to build a prediction model, while the remaining two had applied artificial intelligence. Potential predictors like neonatal fever, birth weight, foetal morbidity and gender, cervicovaginitis and maternal age were identified for the early detection of neonatal sepsis. Moreover, birth weight, endotracheal intubation, thyroid hypofunction and umbilical venous catheter were promising factors for predicting late-onset sepsis; while gestational age, intrapartum temperature and antibiotics treatment were utilised as budding prognosticators for early-onset sepsis detection.ConclusionPrediction modelling approaches were able to recognise promising maternal, neonatal and laboratory predictors in the rapid detection of early and late neonatal sepsis and thus, can be considered as a novel way for clinician decision-making towards the disease diagnosis if not used alone, in the years to come.
Highlights
Neonatal sepsis is the third most prominent cause of mortality among neonates after intrapartum complications and prematurity
Neonates having positive blood culture report before 30 days of life were considered as neonatal sepsis patient [17]; (2) Case–control, cohort—prospective/retrospective studies predicting the prognosis of having neonatal sepsis which is to be culture positive; (3) Prediction model developed through various statistical procedure like machine learning/ logistic regression/artificial intelligence for early detection of neonatal sepsis; (4) The prediction developmental model should be either internally or externally validated, and (5) Articles published in English peer reviewed journal
Apart from the previously mentioned predictors, novel diagnostic marker such as neutrophil CD64, platelet to lymphocyte and neutrophil to lymphocyte can be added to the prediction model for increasing the accuracy of diagnosis of neonatal sepsis as neutrophil CD64 when combined with standard biomarkers like C-Reactive Protein (CRP) and WBC increases the sensitivity and accuracy of diagnosis [10, 37]
Summary
Neonatal sepsis is the third most prominent cause of mortality among neonates after intrapartum complications and prematurity. The main objective of the study was to provide a complete picture of performance of prediction models for early detection of neonatal sepsis. Methods PubMed, Scopus, CINAHL databases were searched and articles which used various prediction modelling measures for the early detection of neonatal sepsis were comprehended. Potential predictors like neonatal fever, birth weight, foetal morbidity and gender, cervicovaginitis and maternal age were identified for the early detection of neonatal sepsis. Conclusion Prediction modelling approaches were able to recognise promising maternal, neonatal and laboratory predictors in the rapid detection of early and late neonatal sepsis and can be considered as a novel way for clinician decisionmaking towards the disease diagnosis if not used alone, in the years to come
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