Biomarkers estimating baseline mortality risk for neonatal sepsis: nPERSEVERE: neonate-specific sepsis biomarker risk model

Background Prognostic biomarker research neonatal sepsis is lacking. We assessed the utility of a validated pediatric prognostic tool called PERSEVERE II that uses decision tree methodology to predict mortality at discharge in neonates who experienced sepsis. Methods Prospective study in a dual-cent...

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Bibliographic Details
Published in:Pediatric research 2023-10, Vol.94 (4), p.1451-1456
Main Authors: Al Gharaibeh, Faris N., Lahni, Patrick, Alder, Matthew N., Wong, Hector R.
Format: Article
Language:English
Subjects:
Biomarkers
Clinical Research Article
Clinical trials
Critical care
Decision trees
Intensive care
Medicine
Medicine & Public Health
Mortality
Pediatric Surgery
Pediatrics
Precision medicine
Sepsis
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Summary:Background Prognostic biomarker research neonatal sepsis is lacking. We assessed the utility of a validated pediatric prognostic tool called PERSEVERE II that uses decision tree methodology to predict mortality at discharge in neonates who experienced sepsis. Methods Prospective study in a dual-center cohort of neonates with sepsis admitted between June 2020 and December 2021. Biomarker analysis was done on serum samples obtained at the time of evaluation for the event. Results In a cohort of 59 neonates with a mortality rate of 15.3%, PERSEVERE II was 67% sensitive and 59% specific for mortality, p 0.27. Amongst PERSEVERE II biomarkers, IL-8 showed good prognostic performance for mortality prediction with a cutoff of 300 pg/mL (sensitivity 100%, specificity 65%, negative predictive value 100%, AUC 0.87, p 0.0003). We derived a new decision tree that is neonate specific (nPERSEVERE) with improved performance compared to IL-8 (sensitivity 100%, specificity 86%, negative predictive value 100%, AUC 0.95, p  
ISSN:0031-3998
1530-0447
DOI:10.1038/s41390-022-02414-z