ArticlePloS one2025
Four-factor nomogram for early-onset sepsis in preterm neonates: Development and internal validation of a stewardship tool.
Article in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEarly-onset sepsis (EOS) remains a leading cause of mortality and neurodevelopmental injury in preterm infants, yet widely used tools (e.g., Kaiser EOS Calculator) are not designed for <35-37 weeks' gestation.
objectiveTo develop and internally validate a concise, clinically interpretable nomogram for EOS risk stratification in preterm neonates and to evaluate its potential for antibiotic stewardship.
methodsWe performed a single-center retrospective cohort study (July 2023-June 2024) including 1,059 preterm infants admitted within 72 h of birth, randomly split 7:3 into training (n = 742) and validation (n = 317). Forty-five maternal and neonatal candidates were screened (univariable tests, LASSO), followed by multivariable logistic regression to build the final model and nomogram. Discrimination (AUC), calibration (Brier score, calibration curve, Hosmer-Lemeshow), and decision-curve analysis (DCA) were assessed; two biologically plausible interactions were prespecified.
resultsFour routinely available variables-gestational age, birth weight, umbilical cord abnormality, and mechanical ventilation within 72 h-composed the final model. In the validation cohort, AUC was 0.818 (95% CI, 0.767-0.868), Brier score 0.158, and Hosmer-Lemeshow P = 0.71; DCA showed net benefit across 5-65% risk thresholds. Using a ≥ 0.70 treatment threshold, the model identified 88% of EOS cases while recommending antibiotics for ~10% of infants. A culture-proven-only sensitivity analysis yielded comparable discrimination (AUC 0.819) with a Brier score 0.041.
conclusionsA four-factor nomogram using EMR-available variables accurately stratifies EOS risk in preterm infants and may support risk-based antibiotic decisions while limiting overtreatment. Prospective multicenter external validation is warranted to confirm generalizability and guide implementation.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.