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Overview :
Mahieu et al developed a bedside score for predicting
nosocomial sepsis in a neonate in the neonatal ICU. The authors are from
University Hospital of Antwerp in Belgium.
Parameters:
(1) duration of total parenteral nutrition (TPN)
(2) C-reactive protein (CRP)
(3) platelet count
(4) temperature
(5) percent neutrophils in the peripheral blood differential
count
|
Parameter |
Finding |
Points |
|
duration of TPN |
none or < 14 days |
0 |
|
|
>= 14 days |
6 |
|
CRP in mg/L |
< 14 mg/L |
0 |
|
|
>= 14 mg/dL |
5 |
|
platelet count |
>= 150,000 per µL |
0 |
|
|
< 150,000 per µL |
5 |
|
temperature |
<= 38.2°C |
0 |
|
|
> 38.2°C |
5 |
|
percent neutrophils |
<= 50% |
0 |
|
|
> 50% |
3 |
where:
• The above
items were used to generate the NOSEP-1 score.
• The
addition of hub catheter and exit site culture results to NOSEP-1 was termed the
NOSEP-2.
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 24
• The higher the score the greater the risk of nosocomial
sepsis.
Performance:
• A score >= 8 was 95% sensitive but 43% specific.
• A score of >= 11 was 60% sensitive and 84% specific.
• A score >= 14 was 26% sensistive and 100% specific.
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