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 |
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 |
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