{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T16:53:12Z","timestamp":1792428792315,"version":"4.5.0"},"reference-count":35,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2021,1,28]],"date-time":"2021-01-28T00:00:00Z","timestamp":1611792000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neonatal-Perinatal Medicine"],"published-print":{"date-parts":[[2021,11,12]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>\n                      In premature infants, clinical changes frequently occur due to sepsis or non-infectious conditions, and distinguishing between these is challenging. Baseline risk factors, vital signs, and clinical signs guide decisions to culture and start antibiotics. We sought to compare heart rate (HR) and oxygenation (SpO\n                      <jats:sub>2<\/jats:sub>\n                      ) patterns as well as baseline variables and clinical signs prompting sepsis work-ups ultimately determined to be late-onset sepsis (LOS) and sepsis ruled out (SRO).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>\n                      At three NICUs, we reviewed records of very low birth weight (VLBW) infants around their first sepsis work-up diagnosed as LOS or SRO. Clinical signs prompting the evaluation were determined from clinician documentation. HR-SpO\n                      <jats:sub>2<\/jats:sub>\n                      data, when available, were analyzed for mean, standard deviation, skewness, kurtosis, and cross-correlation. We used LASSO and logistic regression to assess variable importance and associations with LOS compared to SRO.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      We analyzed sepsis work-ups in 408 infants (173 LOS, 235 SRO). Compared to infants with SRO, those with LOS were of lower GA and BW, and more likely to have a central catheter and mechanical ventilation. Clinical signs cited more often in LOS included hypotension, acidosis, abdominal distension, lethargy, oliguria, and abnormal CBC or CRP ( p\u200a&lt;\u200a0.05). HR-SpO\n                      <jats:sub>2<\/jats:sub>\n                      data were available in 266 events. Cross-correlation HR-SpO\n                      <jats:sub>2<\/jats:sub>\n                      before the event was associated with LOS after adjusting for GA, BW, and postnatal age. A model combining baseline, clinical and HR-SpO\n                      <jats:sub>2<\/jats:sub>\n                      variables had AUC 0.821.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION:<\/jats:title>\n                    <jats:p>\n                      In VLBW infants at 3-NICUs, we describe the baseline, clinical, and HR-SpO\n                      <jats:sub>2<\/jats:sub>\n                      variables associated with LOS versus SRO.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3233\/npm-200578","type":"journal-article","created":{"date-parts":[[2021,1,29]],"date-time":"2021-01-29T12:24:15Z","timestamp":1611923055000},"page":"553-561","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":36,"title":["Clinical and vital sign changes associated with late-onset sepsis in very low birth weight infants at 3 NICUs"],"prefix":"10.1177","volume":"14","author":[{"given":"B.A.","family":"Sullivan","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Division of Neonatology, University of Virginia School of Medicine, Charlottesville, VA, USA"},{"name":"University of Virginia Center for Advanced Medical Analytics, Charlottesville, VA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V.P.","family":"Nagraj","sequence":"additional","affiliation":[{"name":"Department of Research Computing, University of Virginia School of Medicine, Charlottesville, VA, USA"},{"name":"Signature Science, LLC, Charlottesville, Virginia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.L.","family":"Berry","sequence":"additional","affiliation":[{"name":"University of Virginia School of Medicine, Charlottesville, VA, USA"},{"name":"University of Virginia School of Public Health Sciences, Charlottesville, VA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Fleiss","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Neonatology, Columbia University, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Rambhia","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Newborn Medicine, Washington University School of Medicine, St. Louis, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Neonatology, University of Virginia School of Medicine, Charlottesville, VA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Wallman-Stokes","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Neonatology, Columbia University, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Z.A.","family":"Vesoulis","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Newborn Medicine, Washington University School of Medicine, St. Louis, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Sahni","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Neonatology, Columbia University, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Ratcliffe","sequence":"additional","affiliation":[{"name":"University of Virginia School of Public Health Sciences, Charlottesville, VA, USA"},{"name":"University of Virginia Center for Advanced Medical Analytics, Charlottesville, VA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.E.","family":"Lake","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology, University of Virginia School of Medicine, Charlottesville, VA, USA"},{"name":"University of Virginia Center for Advanced Medical Analytics, Charlottesville, VA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.R.","family":"Moorman","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology, University of Virginia School of Medicine, Charlottesville, VA, USA"},{"name":"University of Virginia Center for Advanced Medical Analytics, Charlottesville, VA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.D.","family":"Fairchild","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Neonatology, University of Virginia School of Medicine, Charlottesville, VA, USA"},{"name":"University of Virginia Center for Advanced Medical Analytics, Charlottesville, VA, 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