Gloria P Sosa-Bustamante, Alejandro Covarrubias-Gil, Diana L Colmenero-Carrera, Ulises P Villalpando-Sosa, Arturo M Reyes-Sosa, Carlos Paque-Bautista, Paulina P Reyes-Sosa, Joselin Chavero-Espínola, Alexis D Arroyo-Tovar, Aurelia Del C Ramos-Jiménez, Arturo Reyes-Hernández, Alma P González
NLR and SII were shown to be predictors of diagnosis, severity, and surgical outcome of NEC, although not for mortality. They can be low-cost, and accessible markers from first-level units to specialized neonatal areas.
INTRODUCCIÓN: La enterocolitis necrosante (ECN) es una enfermedad grave en recién nacidos pretérmino (RNPT) que requiere de biomarcadores predictores. Los índices neutrófilo/linfocito (INL), plaqueta/linfocito (IPL) e inmunidad/inflamación sistémica (IIS) han mostrado utilidad en entidades neonatales. El objetivo de la investigación fue evaluar los índices inflamatorios como predictores de presencia, gravedad y mortalidad en ECN en RNPT.
MÉTODOS: Estudio observacional, retrospectivo. Se incluyeron RNPT de 26-36 semanas de gestación, con biometría hemática completa, distribuidos en dos grupos, con ECN (n = 85) y sin ECN (n = 85). Se registraron datos clínicos y hematológicos de los RNPT, así como la evolución y desenlace para los casos de ECN.
RESULTADOS: Se incluyeron 170 RNPT con edad gestacional de 32.5 (RIC: 31-34) semanas y peso de 1,402.5 g (RIC: 1,170-1,691 g), 52% hombres y 48% mujeres. Para ECN, la sensibilidad fue para INL 48%, IPL 8% e IIS 34%; especificidad del 98% de INL, IPL e IIS. Para ECN quirúrgica, sensibilidad del INL del 66%, IPL 20% e IIS 58%; especificidad del 95% de INL, IPL e IIS. Para ECN grave, sensibilidad del INL del 60%, IPL 15% e IIS 45%; especificidad del 90% de INL y 93% de IPL e IIS.
CONCLUSIONES: El INL y el IIS demostraron ser predictores de diagnóstico, gravedad y desenlace quirúrgico de ECN, aunque no para mortalidad. Pueden ser marcadores de bajo costo y accesibles desde unidades de primer nivel hasta áreas neonatales especializadas.
BACKGROUND: Necrotizing enterocolitis (NEC) is a serious disease in preterm newborns (PTNBs) that requires predictive biomarkers. Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immunity-inflammation index (SII) have proven useful in neonatal conditions. The study objective was to evaluate inflammatory indexes as predictors of NEC presence, severity and mortality in PTNBs.
METHODS: Retrospective, observational study. PTNBs at 26-36 weeks’ gestation with complete blood count were included and divided into two groups: those with NEC (n = 85) and without NEC (n = 85). Clinical and hematological data were recorded from participants, along with the course and outcome for those with NEC.
RESULTS: One hundred seventy PTNBs infants with a gestational age of 32.5 (IQR: 31-34) weeks and a weight of 1,402.5 g (IQR: 1,170-1,691 g) were included, 52% male and 48% female. For NEC, sensitivity was 48% for the NLR, 8% for PLR, and 34% for SII; specificity was 98% for NLR, PLR, and SII. For surgical NEC, sensitivity was 66% for NLR, 20% for PLR, and 58% for SII; specificity was 95% for NLR, PLR, and SII. For severe NEC, sensitivity was 60% for NLR, 15% for PLR, and 45% for SII; the specificity was 90% for NLR, and 93% for PLR and SII.
CONCLUSIONS: NLR and SII were shown to be predictors of diagnosis, severity, and surgical outcome of NEC, although not for mortality. They can be low-cost, and accessible markers from first-level units to specialized neonatal areas.