Evidence map›Paper›PMID 40136623›Full record

ArticleDiseases (Basel, Switzerland)2025

An Application for Spatial Frailty Models: An Exploration with Data on Fungal Sepsis in Neonates.

Palaniyandi Paramasivam, Nagaraj Jaganathasamy, Srinivasan Ramalingam, Vasantha Mahalingam, Selvam Nagarajan, Fayaz Ahamed Shaik, Sundarakumar Karuppasamy, Adhin Bhaskar, Padmanaban Srinivasan, Tamizhselvan Manoharan and 2 more

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Article in Diseases (Basel, Switzerland), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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12 authors.

Palaniyandi ParamasivamDepartment of Statistics, ICMR-National Institute for Research in Tuberculosis, Chennai 600 031, Tamil Nadu, India.
Nagaraj JaganathasamyDepartment of Biostatistics, ICMR-National Institute of Immunohaemotology (NIIH), Mumbai 400 012, Maharashtra, India.ORCID 0000-0003-1572-774X
Srinivasan RamalingamDepartment of Epidemiology and Biostatistics, ICMR-National Institute of Epidemiology, Chennai 600 077, Tamil Nadu, India.ORCID 0000-0003-3240-0116
Vasantha MahalingamDepartment of Statistics, ICMR-National Institute for Research in Tuberculosis, Chennai 600 031, Tamil Nadu, India.ORCID 0000-0003-0390-346X
Selvam NagarajanDepartment of Statistics, ICMR-National Institute for Research in Tuberculosis, Chennai 600 031, Tamil Nadu, India.
Fayaz Ahamed ShaikDepartment of Statistics, ICMR-National Institute for Research in Tuberculosis, Chennai 600 031, Tamil Nadu, India.ORCID 0000-0002-6650-3028
Sundarakumar KaruppasamyDepartment of Statistics, ICMR-National Institute for Research in Tuberculosis, Chennai 600 031, Tamil Nadu, India.ORCID 0009-0003-1309-0439
Adhin BhaskarDepartment of Statistics, ICMR-National Institute for Research in Tuberculosis, Chennai 600 031, Tamil Nadu, India.ORCID 0000-0003-2046-020X
Padmanaban SrinivasanDepartment of Statistics, ICMR-National Institute for Research in Tuberculosis, Chennai 600 031, Tamil Nadu, India.
Tamizhselvan ManoharanDepartment of Statistics, ICMR-National Institute for Research in Tuberculosis, Chennai 600 031, Tamil Nadu, India.
Adalarasan NatesanDepartment of Pediatrics, Government Kilpauk Medical College, Chennai 600 010, Tamil Nadu, India.
Ponnuraja ChinnaiyanDepartment of Statistics, ICMR-National Institute for Research in Tuberculosis, Chennai 600 031, Tamil Nadu, India.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundGlobally, neonatal fungal sepsis (NFS) is a leading cause of neonatal mortality, particularly among vulnerable populations in neonatal intensive care units (NICU). The use of spatial frailty models with a Bayesian approach to identify hotspots and risk factors for neonatal deaths due to fungal sepsis has not been explored before.

methodsA cohort of 80 neonates admitted to the NICU at a Government Hospital in Tamil Nadu, India and diagnosed with fungal sepsis through blood cultures between 2018-2020 was considered for this study. Bayesian spatial frailty models using parametric distributions, such as Log-logistic, Log-normal, and Weibull proportional hazard (PH) models, were employed to identify associated risk factors for NFS deaths and hotspot areas using the R version 4.1.3 software and QGIS version 3.26 (Quantum Geographic Information System).

resultsThe spatial parametric frailty models were found to be good models for analyzing NFS data. Abnormal levels of activated thromboplastin carried a significantly higher risk of death in neonates across all PH models (Log-logistic, Hazard Ratio (HR), 95% Credible Interval (CI): 22.12, (5.40, 208.08); Log-normal: 20.87, (5.29, 123.23); Weibull: 18.49, (5.60, 93.41). The presence of hemorrhage also carried a risk of death for the Log-normal (1.65, (1.05, 2.75)) and Weibull models (1.75, (1.07, 3.12)). Villivakkam, Tiruvallur, and Poonamallee blocks were identified as high-risk areas.

conclusionsThe spatial parametric frailty models proved their effectiveness in identifying these risk factors and quantifying their association with mortality. The findings from this study underline the importance of the early detection and management of risk factors to improve survival outcomes in neonates with fungal sepsis.

Indexed as

activated thromboplastinBayesianfrailtyhazardneonatal sepsisspatial

Identifiers

PMID40136623
PMCPMC11941533

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