Hematological scoring system as an early diagnostic tool for neonatal sepsis
Abstract: Sepsis was the
leading cause of death in babies by 30%-50% in developing countries. Early
diagnosis of neonatal sepsis is still a difficult problem because of clinical
features are not specific. Blood culture is the gold standard, but it takes
several days and is expensive. The hematological scoring system (HSS) consists of
hematologic parameters (leucocyte count, polymorphonuclear (PMN) cells,
degenerative changes, and platelet count) for early diagnosis of neonatal
sepsis. Objective To measure HSS as an early diagnostic tool for neonatal sepsis.
Methods A cross sectional study was conducted in March to June 2013. Samples
were collected by consecutive sampling. Fourty neonates suspected sepsis in
neonatology unit H. Adam Malik Hospital, Medan, North Sumatera, underwent
routine blood count, blood culture, and peripheral blood smear. Each hematologic
parameters were analysed using the HSS of Rodwell et al. The hematologic
parameters were total leucocyte count, total PMN cells, total PMN immature, I:T
PMN ratio, I:M PMN ratio, degenerative changes, and platelet count. The total
value revealed HSS score. Diagnostic study parameters were calculated. Results
Ten of fourty neonates had sepsis based on blood culture with positive
predictive value (PPV) 73%, negative predictive value (NPV) 93%, ROC curve
showed cut off point 0.902 (95% CI 0.803 to 1.0).
Author: Fathia Meirina,
Bidasari Lubis, Tiangsa Sembiring, Nelly Rosdiana, Olga R. Siregar
Jounal Code: jpkedokterangg150275
