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. 2022 Jul 10;11(7):928. doi: 10.3390/antibiotics11070928

Table 1.

Predictive scores for the LOS with clinical variables.

Reference Country, Year Method Design Population Scoring System (Points) Main Findings
[27] India, 2003 Prospective Original 80 neonates: 105 episodes (30 definite, 17 probable sepsis and 58 no sepsis)
91% preterm, 93% LBW

  • grunting (2)

  • abdominal distension (2)

  • increased pre-feed aspirate (1)

  • tachycardia (1)

  • hyperthermia (1)

  • chest retraction (1)

  • lethargy (1)

 Score different in septic and no septic infants.
Most prevalent signs in septic babies: apnea, lethargy, tachycardia.
Most specific signs in septic babies: grunting, hypothermia, chest retractions.
[28] Turkey, 2005 Retrospective Original and external validation (comparison with NOSEP score of Mahieu et al.) 102 neonates: 132 episodes (51 blood culture (+), 51 no sepsis)

  • respiratory symptom (2)

  • abdominal distension (2)

  • feeding intolerance (2)

  • hypotension (2)

  • bradycardia (2)

  • lowest and highest body temperature difference (2)

 Score different in septic and no septic infants.
Feeding intolerance and higher I:T ratio as significant predictors of NS.
[29] India, 2008 Prospective Validation (of Singh et al.) 202 neonates: 220 episodes (60 definite sepsis)
Weight: 1000–2500 g

  • grunting

  • abdominal distension

  • increased pre-feed aspirate

  • tachycardia

  • hyperthermia

  • chest retraction

  • lethargy

≥1 = positive clinical score		 The most frequent signs in septic infants: lethargy, apnea and pre feeds aspirates.
All clinical signs decreased in frequency from 0 h to 24 h.
Different score at 0 h and at 24 h: Se better at 0 h (all sick neonates included), Sp, PPV, NPV better at 24 h.
Better prediction of NS at 24 h (PPV↑ at 24 h).
Score combined with sepsis screen: ↑Se, NPV but ↓Sp, PPV
[30] Bangladesh, 2010 Retrospective Validation (of Singh et al.) and original 160 neonates: 193 episodes (105 culture (+) in 98 neonates, 88 culture (−) in 79 neonates)GA ≤ 33 weeks (very preterm),
≤72 h admitted to hospital

  • grunting (2)

  • abdominal distension (2)

  • poor feeding (1)

  • tachycardia (1)

  • hyperthermia (1)

  • respiratory distress (1)

  • lethargy (1)

 First bedside clinical score for very premature neonates in a low-resource setting.
This external validation performed significantly lower Sensitivity than the original study.
As the number of sings presented within 48 h of sepsis evaluation was increased, Se and NPV were reduced, while Sp and PPV were augmented.
Sensitivity reducing when more than 1 signs were present.