The clinical application of subcutaneous thoracic ratio and capillary leakage index on the occurrence of capillary leak syndrome in neonates with sepsis.

OBJECTIVE

To evaluate the predictive and prognostic value of the subcutaneous-thoracic ratio (S/T) and capillary leakage index (CLI) for capillary leak syndrome (CLS) in neonatal sepsis.

MATERIALS AND METHODS

A cohort of 196 neonates with sepsis, admitted to a tertiary children's hospital in southwestern China between January 2019 and March 2021, was included in the study. The neonates were divided into two groups: the CLS group ( = 55) and the non-CLS group ( = 55). Multivariate logistic regression and receiver operating characteristic (ROC) curve analysis were performed to identify key predictors of CLS.

RESULTS

Both S/T and CLI were found to be independent risk factors for CLS in neonatal sepsis ( < 0.05). The median S/T values for the CLS group and non-CLS group were 9.0% and 7.1%, respectively, while the median CLI values were 8.5 and 3.2. The optimal thresholds for predicting CLS were identified as 8.1% for S/T (sensitivity: 67.3%, specificity: 70.9%) and 3.3 for CLI (sensitivity: 78.2%, specificity: 56.4%). Notably, the combination of S/T and CLI yielded improved predictive performance, with a sensitivity of 81.8% and specificity of 60.0%. However, neither S/T nor CLI were significantly associated with prognosis, as no difference was observed between survivors and non-survivors ( > 0.05).

CONCLUSION

The combined application of S/T and CLI provides an effective tool for predicting the occurrence of CLS in neonatal sepsis. However, these indicators do not demonstrate prognostic value for survival outcomes.