Evaluation of risk factors for fatal neonatal sepsis.

OBJECTIVE To evaluate risk factors for fatal neonatal sepsis. DESIGN Prospective study. SETTING Referral neonatal unit of a teaching hospital. SUBJECTS 171 neonates admitted with sepsis. METHODS Clinical examination and investigations on the day of admission were recorded and the neonates followed up to determine the final outcome. RESULTS The overall fatality was 48.5%. In the univariate analysis, the factors significantly associated with death were weight, gestational age, age at onset of sepsis, hypothermia, requirement of IPPV, presence of refractory septic shock, neutropenia, metabolic acidosis and raised prothrombin time. However, in the multivariate analysis, only neutropenia, metabolic acidosis, increased prothrombin time and refractory septic shock retained their significance. The adjusted odd's ratio (95% confidence interval) were 0.095 (0.04 = 0.22), 1.14 (1.04-1.25), 1.04 (1.002-1.08) and 11.82 (5.47-69.40), respectively. CONCLUSION Even in a setting with high fatality rates, high risk of mortality in neonatal sepsis can be identified and targeted for intensive intervention.