Hematological scoring system as an early diagnostic tool for neonatal sepsis

Abstract

Background Sepsis was the leading cause of death in babies by30%-50% in developing countries. Early diagnosis of neonatalsepsis is still a difficult problem because of clinical features are notspecific. Blood culture is the gold standard, but it takes several daysand is expensive. The hematological scoring system (HSS) consistsof hematologic parameters (leucocyte count, polymorphonuclear(PMN) cells, degenerative changes, and platelet count) for earlydiagnosis of neonatal sepsis.Objective To measure HSS as an early diagnostic tool for neonatalsepsis.Methods A cross sectional study was conducted in March toJune 2013. Samples were collected by consecutive sampling.Fourty neonates suspected sepsis in neonatology unit H. AdamMalik Hospital, Medan, North Sumatera, underwent routineblood count, blood culture, and peripheral blood smear. Eachhematologic parameters were analysed using the HSS of Rodwellet al. The hematologic parameters were total leucocyte count, totalPMN cells, total PMN immature, I:T PMN ratio, I:M PMN ratio,degenerative changes, and platelet count. The total value revealedHSS score. Diagnostic study parameters were calculated.Results Ten of fourty neonates had sepsis based on blood culture􀁕􀁈􀁖􀁘􀁏􀁗􀁖􀀑􀀃􀀷􀁋􀁈􀀃􀀫􀀶􀀶􀀃􀁖􀁆􀁒􀁕􀁈􀀃􀂕􀀗􀀃􀁋􀁄􀁇􀀃􀁖􀁈􀁑􀁖􀁌􀁗􀁌􀁙􀁌􀁗􀁜􀀃􀀛􀀓􀀈􀀏􀀃􀁖􀁓􀁈􀁆􀁌􀁉􀁌􀁆􀁌􀁗􀁜􀀃􀀜􀀓􀀈􀀏􀀃with positive predictive value (PPV) 73%, negative predictivevalue (NPV) 93%, ROC curve showed cut off point 0.902 (95%CI 0.803 to 1.0).Conclusion 􀀶􀁆􀁒􀁕􀁈􀀃􀀫􀀶􀀶􀀃􀂕􀀗􀀃􀁆􀁒􀁘􀁏􀁇􀀃􀁅􀁈􀀃􀁘􀁖􀁈􀁇􀀃􀁄􀁖􀀃􀁄􀁑􀀃􀁈􀁄􀁕􀁏􀁜􀀃􀁇􀁌􀁄􀁊􀁑􀁒􀁖􀁗􀁌􀁆􀀃tool for neonatal sepsis.