Baczynski et al reported risk factors for mortality for a preterm neonate with a bloodstream infection. These can help to identify a patient who may require more aggressive management. The authors are from Mount Sinai Hospital, University of Toronto and Sunnybrook Health Sciences Center.
Patient selection: preterm neonate (< 35 weeks; data indicates most are < 31 weeks); with a bloodstream infection
Outcome: mortality within 7 days
Early predictors of mortality (within 4 hours of disease onset):
(1) lowest mean arterial blood pressure (aOR 0.91); mean 31 in non-survivors versus 43 in survivors)
(2) highest base deficit (aOR 1.18; mean 15.9 mmol/L in non-survivors and 3.0 in survivors)
where:
• A high base deficit indicates metabolic acidosis.
• Serum lactate is not listed as a variable but would be expected to be high in non-survivors.
Performance:
• The area under the ROC curve was 0.91.
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