Circulating Biomarkers of Endothelial Dysfunction Predict Mortality in Newborn Sepsis
Bibliographic record
Abstract
Background. Biomarkers of endothelial activation predict sepsis severity and outcomes in adults but their role in early newborn sepsis has not been reported. We hypothesize that these circulating biomarkers will identify young infants with sepsis and predict their clinical outcome. Methods. Four hundred twenty infants aged 0–60 days of life with suspected sepsis were recruited on presentation to a referral hospital in Bangladesh. Serum was collected at admission and Ang-1, Ang-2, sICAM and sVCAM concentrations were determined by ELISA. The primary outcome was mortality (n = 18); the secondary outcome was bacteremia (n = 11). Using a 1:3 matched case-control design, infants who died or had culture-confirmed bacteremia (cases) were matched on birthweight and age with survivor/non-bacteremic infants (control). Results. Serum Ang-2 concentration at presentation was higher among infants who subsequently died of sepsis compared to survivors (5.4 pg/mL versus 3.3, adjusted OR 2.19, p = 0.014) and the relative odds of death increased across Ang-2 tertiles (p trend = 0.0156). Similarly, the serum Ang-2:Ang-1 ratio was higher among infants who died compared to survivors (0.5 versus 0.2, aOR 2.90, p = 0.008) and the relative odds of death increased across tertiles of Ang 2:Ang-1 (p-trend = 0.0254). Among infants with bacteremia, Ang-2:Ang-1 was higher compared to controls (0.25 versus 0.20. aOR 5.82, p = 0.044). sICAM levels trended with bacteremia (262.0 pg/mL versus 158.5 pg/mL, aOR 2.38, p = 0.053) but not with mortality. Conclusion. This is the first study to demonstrate an association between biomarkers of endothelial dysfunction and mortality in young infants with suspected sepsis. If validated in additional studies, their use in rapid point-of-care tests could risk-stratify infants with suspected sepsis. Since these markers are mediators of endothelial function, they also represent potential targets for intervention to improve clinical outcomes. Disclosures. All authors: No reported disclosures.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".