Karakteristik Klinis dan Laboratorium, Sertaprediktor Kematian pada Neonatusdengan Sepsis di RSUP H Adam Malik Medan

Abstract

Background Neonatal mortality remains a significant global concern, with sepsis being a leading contributor to the high mortality and morbidity rates. This burden is highest in low and middle income countries including Indonesia where diagnosis of sepsis including t he identification and antibiotic susceptibility reporting is challenging. Therefore the true incidence of neonatal sepsis remains unknown in this setting. Several factors have been identified with association to increased risk of neonatal sepsis such as ne onatal factors, maternal factors and medical intervention. Aim This study aims to determine the profiles of neonates with sepsis at H. Adam Malik Hospital and the predictors of mortality. M ethods A retrospective study was conducted on the medical records of 132 neonates diagnosed with neonatal sepsis at H. Adam Malik Hospital between January 2022 and September 2 023. Demographic data, clinical presentations, laboratory findings, blood cultures, medical interventions, and outcomes were obtained from the NIC U database and chart review. Diagnosis of sepsis was classified into clinical or proven sepsis , and outcomes were determined as recovered or death. Univariate, bivariate and multivariate analysis were performed to compare the characteristics and to determine the predictors of mortality, with statistical significance of 0.05. Results T here were a total of 132 neonates that were clinically suspected as sepsis, with 70 of these were confirmed with culture. The case fatality rate was 38.6%. It was found that EOS, mottled skin, lethargy, altered consciousness, bradycardia, cyanosis, prolonged CRT, oxygen desaturation, respiratory distress, abdomen distension, food intolerance, hyperglycemia, metabolic acidosis, oliguria, neutrophil count, NLR, procalcitonin, b lood glucose, oxygen supplementary type, central venous access, parenteral nutrition and length of stay have associations with death. Conclusio n. Early onset of sepsis, altered consciousness, cyanosis, neutrophil count, blood glucose and length of stay are predictors of death in neonatal sepsis.