Healthcare-associated neonatal sepsis

Risk of symptomatic infection and duration of disease

Neonatal sepsis is characterised in accordance with the definition set out in ECDC’s point prevalence survey of healthcare-associated infections and antimicrobial use in European acute care hospitals with the code NEO-LCBI – laboratory-confirmed bloodstream infection in neonates (ECDC, 2012).

The entire disease model was based on the systematic review of the natural history of neonatal sepsis, conducted for the purpose of estimating burden of disease by Haller et al. (2015, in press). Given the lack of studies referring to all sepsis in term infants, this outcome tree represents very low weight birth (VLBW) infants. This must be taken into account when inputting the number of cases.

Model input summary

Table 1. Transition probabilities used in the outcome tree

 Health outcome
 (Health state)

Distribution of health states in health outcome

Transition probability

Source/assumption

Fatal cases following symptomatic infection

 

2-14%

Haller, 2015

Vision impairment

 

9%

Haller, 2015

Hearing impairment

 

4%

Haller, 2015

Cerebral palsy

 

8%

Haller, 2015

Impaired neuro development

 

14%

Haller, 2015

Permanent impaired neuro development

 

67-83%

Haller, 2015

Table 2. Disability weights and duration

Health outcome
(Health state)

Disability Weight (DW) (Haagsma, 2015)

Duration

DW

Label

In years

Source/assumption

Symptomatic infection

0.125-0.655

Range between Infectious disease, acute episode, severe and

Intensive care unit admission DWs

0.082

Haller, 2015

Vision impairment

0.004-0.171

From lowest to highest vision impairment related DWs

 

Remaining life expectancy

Haller, 2015

Hearing impairment

0.008-0.103

From lowest to highest hearing loss related DWs

Remaining life expectancy

Haller, 2015

Cerebral palsy

0.054-0.425

From lowest to highest Motor plus cognitive impairments related DWs

Remaining life expectancy

Haller, 2015

Impaired neuro development

0.054-0.425

From lowest to highest Motor plus cognitive impairments related DWs

3.4-8.6

Haller, 2015

Permanent impaired neuro development

0.054-0.425

From lowest to highest Motor plus cognitive impairments related DWs

Remaining life expectancy

Haller, 2015

References

European Centre for Disease Prevention and Control. Point prevalence survey of healthcare-associated infections and antimicrobial use in European acute care hospitals – protocol version 4.3. Stockholm: ECDC; 2012. Available at: http://ecdc.europa.eu/en/publications/Publications/0512-TED-PPS-HAI-antimicrobial-use-protocol.pdf

Haagsma JA, Maertens de Noordhout C, Polinder S, Vos T, Havelaar AH, Cassini A, Devleesschauwer B, Kretzschmar ME, Speybroeck N, Salomon JA. Assessing disability weights based on the responses of 30,660 people from four European countries. Population Health Metrics 2015; 13: 10

Haller S, Deindl P, Cassini A, Suetens C, Zingg W, Abu Sin M, Velasco E, Weiß B, Ducomble T, Sixtensson M, Eckmanns T, Thomas H. Evidence-based outcome tree for neurological sequelae of sepsis in very low birth weight infants. 2015, Submitted