Smrithi Gm, Gayathri Renganathan, Smitha D'sa
There was moderate correlation between the studied hematological indices and positive cultures, suggesting their potential role as inflammatory markers. Larger prospective trials should be conducted to further validate their potential clinical value.
BACKGROUND: The utility of Systemic Inflammatory Indices as accurate indicators of neonatal sepsis remains underexplored in the Indian population. This study will assist in determining whether these indices can be used to predict neonatal sepsis at the bedside and as an early sensitive predictor of sepsis in preterms.
METHODS: A prospective case-control study was done, where the Systemic Inflammatory Indices of the two groups of preterms - one control group without sepsis and one case group with culture proven sepsis-were compared to assess their value in predicting Neonatal Sepsis. Data from 138 preterm neonates were used in the present study. Six Systemic Inflammatory Indices were calculated - Systemic Immune Inflammatory Index (SII), Systemic Inflammation Response Index (SIRI), PanImmune Inflammation Value (PIV), Neutrophil to Lymphocyte Ratio (NLR), Platelet to Lymphocyte Ratio (PLR) and Monocyte to Lymphocyte Ratio (MLR). These values from both the case and control groups were compared.
RESULTS: Platelet count had the highest predictive value, with an AUC value of 0.715(95% CI 0.628-0.802, p<0.001) and optimal cut-off value of 219500 cells/cu mm. It had a sensitivity of 75.4 and specificity of 65.2. PIV had an AUC of 0.665(95% CI 0.574-0.755, p=0.001), a sensitivity of 60.9, and a specificity of 68.1. For PLR, Sensitivity and specificity were 72.5 and 58, respectively, with an AUC of 0.668(95% CI 0.577-0.758, p=0.001). With sensitivity and specificity of 66.7 and 62.3 respectively, SII had an AUC of 0.65(95% CI 0.558-0.743, p=0.002). SIRI, NLR and MLR did not demonstrate statistically significant differences between the groups(p>0.05).
CONCLUSION: There was moderate correlation between the studied hematological indices and positive cultures, suggesting their potential role as inflammatory markers. Larger prospective trials should be conducted to further validate their potential clinical value.