Sensitivity of the Kaiser Permanente early-onset sepsis calculator: A ... - The Lancet
Kuzniewicz et al. (2017) California, USA Prospective single-centre cohort 2010 – 2015 Baseline period: 95,543 babies Calculator period: 56,261 babies ≥35 weeks gestation Epoch 1: 24 cases of EOS 4 missed by calculator. Epoch 2: 15 cases of EOS 2 missed by the calculator, plus 4 additional possible mises Epoch 3: 12 cases of EOS 2 missed by calculator as confirmed following d/w Dr Kuzniewicz Antibiotic use reduced from 5.0% to 2.6% low Dhudasia et al. (2018) Philadelphia, USA 'retrospective' single-centre cohort Epoch 1: March 2014-May 2015 Epoch 2: July 2015 - October 2016 Epoch 1: 5692 babies Epoch 2: 6090 babies ≥36 weeks gestation 4 cases of EOS: 1 × GBS, 3 × E. coli maximum 3 misses, minimum 1 miss Case 1 E. coli - maternal temp 38.8C, on parenteral antibiotics, initial risk score: 1.54, after examination: 7.66 - could have been a delay in treatment, depending on how old baby was when symptoms developed F = possible miss Case 2 GBS – score at birth 0.3. Tachypnoeic at 36ho...