Prognostic value of echocardiography parameters, peripheral blood T lymphocyte subpopulations, NF-κB, and CD64 levels in neonatal sepsis.

Abstract

Background: To evaluate the prognostic value of echocardiography parameters, T lymphocyte subpopulations, NF-κB, and CD64 levels in neonatal sepsis.

Methods: A retrospective analysis was conducted on 78 neonates treated for sepsis between January 2018 and December 2022, comprising 64 with poor prognosis and 14 with good prognosis. Among them, 51 were critically ill and 27 were non-critically ill. Echocardiographic parameters, T-lymphocyte subpopulations, NF-κB, and CD64 levels were compared across different prognosis and severity groups. Factors influencing prognosis were identified through multivariate logistic regression analysis.

Results: The left ventricular ejection fraction (LVEF), left ventricular fractional shortening (LVFS), CD3+, and CD4+ T lymphocyte levels in critically ill neonates were (61.15±8.22)%, (32.26±6.61)%, (45.56±7.12)%, and (26.61±6.80)%, respectively, significantly lower than those of non-critically ill neonates (all P < 0.05). The levels of NF-κB and CD64 in critically ill neonates were (18.11±2.61) mg/L and (7.42±1.15)%, respectively, significantly higher than those of non-critically ill neonates (all P < 0.05). Logistic regression analysis showed that LVEF, LVFS, CD4+, CD64, and disease severity were the factors influencing prognosis in neonatal sepsis (all P < 0.05). The area under the ROC curve for the logistic regression equation in predicting prognosis in neonatal sepsis was 0.878, with sensitivity and specificity of 85.30% and 84.10%, respectively.

Conclusion: Echocardiography parameters, T lymphocyte subpopulations, NF-κB, and CD64 levels are associated with neonatal sepsis severity. LVEF, LVFS, CD4+ T lymphocytes, CD64, and disease severity are linked to prognosis, suggesting their potential as prognostic indicators for neonatal sepsis.