학술논문

Thromboelastometry and prediction of in‐hospital mortality in neonates with sepsis.
Document Type
Article
Source
International Journal of Laboratory Hematology. Feb2024, Vol. 46 Issue 1, p113-119. 7p.
Subject
*STATISTICS
*NEONATAL sepsis
*SCIENTIFIC observation
*NEONATAL intensive care
*CONFIDENCE intervals
*MULTIVARIATE analysis
*THROMBELASTOGRAPHY
*BLOOD coagulation
*RETROSPECTIVE studies
*NEONATAL intensive care units
*MULTIPLE organ failure
*HEMOSTASIS
*MANN Whitney U Test
*HOSPITAL mortality
*RISK assessment
*HOSPITAL care
*CHI-squared test
*DESCRIPTIVE statistics
*PREDICTION models
*DATA analysis
*RECEIVER operating characteristic curves
*DATA analysis software
*PROPORTIONAL hazards models
*DISEASE complications
*EVALUATION
*CHILDREN
Language
ISSN
1751-5521
Abstract
Introduction: This study aimed at evaluating the role of rotational thromboelastometry (ROTEM) assays in the prediction of in‐hospital mortality of neonates with sepsis. Methods: Over a 6‐year period, 129 neonates with confirmed sepsis, hospitalized in our neonatal intensive care unit (NICU) were included in the study. Demographics, clinical, and laboratory data were recorded at the sepsis onset and ROTEM assays were performed. Modified neonatal multiple organ dysfunction (NEOMOD) and neonatal sequential organ failure assessment (nSOFA) were calculated simultaneously. Mortality during in‐hospital stay was the main outcome measure. Results: In‐hospital mortality was associated with patient intense hypocoagulability expressed by lower ROTEM MCF in the INTEM assay. The INTEM MCF demonstrated the best prognostic performance for NICU mortality in septic neonates among the other ROTEM parameters but without statistical significance (area under the curve [AUC] = 0.731; 95% confidence interval [CI]: 0.593–0.869). Conclusion: Our results indicate that ROTEM INTEM MCF parameter has good predictive capacity for in‐hospital mortality of septic neonates, similar to that of modified NEOMOD score, nSOFA score, and platelet count, highlighting the integral role of coagulation in sepsis pathophysiology. Hence, ROTEM could serve as a valuable monitoring tool to identify neonates at risk. [ABSTRACT FROM AUTHOR]