Infants Model Calculator

This calculator can help clinicians stratify the risk levels of invasive bacterial infections among full-term neonates.

The Data you input will not be recorded and stored.

This is for your reference only, as peer review is ongoing

Calculator

Items

Value

Age
(day)

day

Gestational age
(week)

week

CSF red blood cell count
(cells/μl)

cells/μl

Antibiotic pretreatment before admission
(Yes or No)

Ill-appearances
(Yes or No)

Abnormal neurological signs
(Yes or No)

Age at admission >3 days
(Yes or No)

White blood cell(WBC)
(cells/μl)

cells/μl

Neutrophil percentage(NPC)
(%)

C-reactive protein(CRP)
(mg/L)

mg/L

procalcitonin(PCT)
(ng/ml)

ng/ml

Result

Risk =

Subjects

The algorithm was derived from 1053 Chinese full-term neonates aged 0-28 days suspected of invasive bacterial infections and accepted lumbar puncture and blood culture.
Neonatal invasive bacterial infections were confirmed by pathogenic bacteria investigation from blood and/or cerebrospinal fluid.

How to use

After inputting measurements of ill-appearances (Yes, No), abnormal neurological signs (Yes, No), age at admission >3 days (Yes, No), white blood cell(WBC) (cells/μl), neutrophil percentage (NPC) (%), C-reactive protein(CRP) (mg/L) and procalcitonin(PCT) (ng/ml), the patient can be automatically classified as having a high or low risk according to the algorithm presented at the bottom of the web page.
If a patient is at high risk, he/she is strongly suggested to be hospitalized for pathogenic investigation.
If a patient is at low risk, antibiotics using and hospitalization are not urgent, and a short-term observation and reassessment in the management of these patients may be more appropriate.

Note

Ill-appearances: present one or more signs including hypothermia, lethargy, poor feeding, recurrent vomit (excluding surgical disease), jaundice aggravation, highly pitched cry, cyanosis, apnea, etc.
Abnormal neurological signs: present one or more signs including seizure, irritability, abnormal tension, hyporeflexia and bulging anterior fontanelle.
WBC, CRP and PCT should be administrated within 24 hours on admission.
Patients older than 28 days, preterm neonates, with traumatic LP or with antibiotic pretreatment are not applicable to this calculator.

Algorithm

The Sequential algorithm

Chen et al, A Novel Algorithm with Paired Predictive Indexes to Stratify the Risk Levels of Neonates with Invasive Bacterial Infections: A Multicenter Cohort Study.