Prognostic value of red cell distribution width, platelet parameters, and the hematological scoring system in neonatal sepsis

Mousa, Suzan Omar; Moustafa, Asmaa N; Aly, Hend M

doi:10.4103/ejh.ejh_12_19

Cited by 8 publications

(10 citation statements)

References 3 publications

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“…These variations are matched with the findings of Chang et al. , 2018 regarding NGAL, but on the other hand, they are not matched with prior studies regarding the TLC, CRP, HSS, and platelets, which may be because of the difference in the population studied and the eligibility criteria [ 18 , 25 , 26 ].…”

Section: Discussionsupporting

confidence: 76%

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Clinical assessment of neutrophil gelatinase-associated lipocalin as a potential diagnostic marker for neonatal sepsis: a prospective cohort study

et al. 2022

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Sepsis is a life-threatening condition associated with high morbidity and mortality rates among neonates. Clinical diagnosis is limited due to the neonates’ unspecific signs and symptoms as well as the long time required to obtain the blood culture results. Consequently, there is an urgent need for new biomarkers to early diagnose neonatal sepsis. We aimed to evaluate Neutrophil Gelatinase-Associated Lipocalin (NGAL) diagnostic performance to detect neonatal sepsis. We enrolled 30 neonates with sepsis admitted to the neonatal intensive care units and 30 age- and sex-matched healthy neonates recruited from the neonatal outpatient clinic during their routine follow-up visits. We measured NGAL levels by sandwich enzyme-linked immunosorbent assay, the C-reactive protein (CRP) with nephelometry technique using BN II nephelometer, and the complete blood count by Mindray BC-6800 analysers. NGAL, CRP, TLC, haemoglobin, and platelet levels showed significant differences between cases and control (all p < .001). Of the 30 neonates with sepsis, 17 neonates (56.7%) survived. At 0 h, the NGAL level showed no statistically significant difference between the non-survivors and survivors’ groups; however, after 96 h, NGAL was significantly higher in the non-survivors group ( p ˂ .001). Our diagnostic analysis showed that NGAL levels have strong discrimination power to early differentiate neonates with sepsis; at the 475.00 pg/ml cut-off value, NGAL showed both sensitivity and specificity of 100% with an area under curve of 100%. Conclusion: Our study suggests that NGAL could be a promising biomarker for neonatal sepsis detection. Further studies with larger sample sizes and survival analysis are warranted to confirm this finding and to clarify the efficacy of NGAL in survival prediction. Key findings NGAL level was high in neonates with sepsis NGAL level was high in non-survived neonates NGAL could be a promising diagnostic marker for sepsis

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Section: Discussionsupporting

confidence: 76%

“…At the same time, CRP and TLC have high specificity but low sensitivity. Previous literature has suggested that NGAL upsurge is considered specific for sepsis [ 3 , 18–20 ]. Whereas, haemoglobin and platelet are decreased in sepsis patients due to decreased erythropoietin levels and the megakaryocytopoiesis process [ 21 , 22 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical assessment of neutrophil gelatinase-associated lipocalin as a potential diagnostic marker for neonatal sepsis: a prospective cohort study

et al. 2022

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“…Martin et al [19] reported significantly higher median RDW levels amongst the non-survivors (p <0.003). A study by Ellahony et al (2017) [13] reported a positive association of RDW with mortality (OR, 1.31; 95% CI, 1.24-1.39).Furthermore, Mousa and colleagues [25] identified that RDW was most sensitive (77.8%) mortality predictor followed by mean platelet volume (MPV)(61.1%) and platelet distribution width (PDW) (50%). These pieces of evidence indicate the prognostic role of increased RDW in predicting mortality in neonatal sepsis.…”

Section: Discussionmentioning

confidence: 99%

Utility of Red Cell Distribution Width (RDW) In Diagnosis and Prognosis of Early-Onset Neonatal Sepsis in Term Neonates

et al. 2021

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Objective: To assess the increased Red Cell Distribution Width (RDW) in diagnosis and prognosis of early-onset neonatal sepsis in term neonates. Methods: In a prospective, observational study, we enrolled term neonates ( 37 weeks of gestation) clinically suspected for Early-Onset Neonatal Sepsis (EONS) (within 7 days of birth). A cut-off of 18% and above was taken to consider RDW as abnormal or increased. The primary outcome was to assess the relation of increased RDW with in-hospital mortality. The secondary outcome was to determine the diagnostic yield of increased RDW in culture-proven sepsis. Results: In 166 neonates, 60% were males. Increased RDW was seen in 42.42% of neonates and 15.75% of neonates had positive blood culture. Compared to normal RDW, in-hospital mortality was significantly higher in neonates with increased mortality (27.14% vs. 10.52%, respectively; p=0.006). Also, abnormal RDW was seen in 46.15% of neonates with positive blood culture compared to 35.25% of neonates with negative blood culture (p<0.0001). Thus, elevated RDW had a sensitivity of 44.4% and specificity of 57.97% in the diagnosis of EONS. Conclusion: Increased RDW can be a diagnostic as well as a prognostic marker in neonates with EONS. Such observation indicates it may serve as a simple and easily available marker for EONS in resource-limited settings. However, these findings need to be confirmed in a larger sample. Doi: 10.28991/SciMedJ-2021-0303-7 Full Text: PDF

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“…The 37 excluded did not follow our inclusion or exclusion criteria, or were case reports, letters to editor, narrative review or editorial. Finally, 12 studies were ultimately included in the systematic review [ 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 ]. ( Figure 1 ).…”

Section: Resultsmentioning

confidence: 99%

Mean Platelet Volume in Neonatal Sepsis: Meta-Analysis of Observational Studies

et al. 2022

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Introduction: Early onset neonatal sepsis (EONS), particularly in preterm sepsis, is a potentially fatal issue. Evaluation of mean platelet volume (MPV) as an EONS predictor was the goal. Methods: Four databases were used to conduct a systematic evaluation of cohort and case–control studies. Up till the end of October 2022, 137 articles were found utilizing the search method. Following the review, 12 studies were included. Leukocytes, MPV, platelets, gender, birth weight, gestational age, mortality, and C-reactive protein (CRP) were all taken into account while analyzing the prediction of EONS. Inverse-variance methodology and the random-effects model were used. Using GRADE, the evidence’s quality was evaluated. Results: Neonatal patients with sepsis had significantly higher MPV levels than do neonates without sepsis (MD 1.26; 95% CI 0.89–1.63; p < 0.001). An increased MPV during the first 24 h postpartum was associated with high CRP values and high risk of neonatal mortality. In the investigations, the MPV cutoff for sepsis patients was 9.95 (SD 0.843). Overall certainty of the evidence was very low. Conclusions: The increased MPV during the first 24 h postpartum may be predictive of EONS and mortality. Future studies are warranted.

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Prognostic value of red cell distribution width, platelet parameters, and the hematological scoring system in neonatal sepsis

Cited by 8 publications

References 3 publications

Clinical assessment of neutrophil gelatinase-associated lipocalin as a potential diagnostic marker for neonatal sepsis: a prospective cohort study

Clinical assessment of neutrophil gelatinase-associated lipocalin as a potential diagnostic marker for neonatal sepsis: a prospective cohort study

Utility of Red Cell Distribution Width (RDW) In Diagnosis and Prognosis of Early-Onset Neonatal Sepsis in Term Neonates

Mean Platelet Volume in Neonatal Sepsis: Meta-Analysis of Observational Studies

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