Time to Recovery and its Predictors among Neonates with Sepsis at St . Paul’s Hospital Millennium Medical College

Abstract

Background: Neonatal sepsis is a systemic infection occurring in infants during the first 28 days of life. The lack of neonatal sepsis survival is high worldwide, even though it is higher in developing countries. Along with being incredibly difficult to diagnose and having a complicated nature, neonatal sepsis’s time to recovery and its predictors are not well investigated. Besides, most previous studies focused on predictors of time to death. Objective: To determine a time to recovery and its predictors among neonates with sepsis at St. Paul’s Hospital Millennium Medical College. Methods: A retrospective cohort study design spanning five years was employed among 383 septic neonates selected by a simple random sampling technique from January 2018 to December 2022. The data were exported from Epi Info to Excel and transferred to Stata version 15 for analysis. Kaplan Meier and long-rank were used to determine the probability of recovery and equality of survival functions between groups of explanatory variables respectively. The proportional hazard assumption fulfillment, model goodness of fit, and multicollinearity were tested using a global test (X2 (7) =7.78, P-value=0.3528), cox-Snell residual test, and variance inflation factor (Mean VIF=1.46) respectively. Adjusted hazard ratios were used to determine the strength of prediction after determining crude hazard ratios at p-value of 0.05 by employing the Cox proportional hazard regression model. The findings were presented as graphs, tables, and text. Result: The study’s response rate was 365(95.3%). Three hundred fifty-eight (98.1%) of neonatal sepsis were early onset. The median recovery time from neonatal sepsis was 4.00 neonatal days. The time to recovery from neonatal sepsis was 0.7, and 0.75 times less likely enhanced among septic neonates with respiratory disorders syndrome (RDS) (AHR=0.70, 95% CI: 0.547, 0.907), and low birth weight (LBW) (AHR=0.75, 95% CI: 0.565, 0.989) respectively. But it was 1.76 and 1.70 times more likely enhanced among neonates who were treated with continuous positive airway pressure (CPAP) (AHR= 1.76, 95% CI: 1.268, 2.434), and IV fluid (AHR= 1.696, 95% CI:1.269, 2.267) respectively. Conclusion: The median time to recover from neonatal sepsis was 4 neonatal days. LBW, RDS, CPAP, and IV fluid-based medical care were significant predictors of the time to recovery. Working on the predictors could improve recovery time from neonatal sepsis