Diagnostic Value of Rodwell Hematological Scoring System Compared to Neutrophil Lymphocyte Count Ratio (NLCR) in Diagnosing Early Onset Neonatal Sepsis

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Asia Pacific Journal Paediatric and Child Health, Volume 3, Jul - Sep 2020

Diagnostic Value of Rodwell Hematological Scoring System Compared to Neutrophil Lymphocyte Count Ratio (NLCR)

in Diagnosing Early Onset Neonatal Sepsis

Pitra Sekarhandini 1 , Dwi Hidayah 1 , Annang Giri Moelyo 1​

ABSTRACT

Background: Neonatal sepsis is still a major health problem worldwide due to its high morbidity and mortality. Clinical symptomps are nonspecific. Blood culture is a gold standard for diagnosis of neonatal sepsis, although the process requires significant time. Early diagnosis of early onset neonatal sepsis is difficult. A number of novel diagnostic tests are being investigated for establishing the diagnosis of neonatal sepsis.

Objective: To determine the diagnostic value of Rodwell Hematological Scoring System (RHSS) compared to Neutrophil to Lymphocyte Count Ratio (NLCR) in the diagnosis of neonatal sepsis and NLCR cut-off point.

Methodology: Cross-sectional observational analytic study was conducted at Neonatology Division in Dr. Moewardi Hospital from October 2018 to October 2019. Blood samples of neonates fulfilling the inclusion criteria underwent hematological testing for counting Rodwell Hematological Scoring System (RHSS), Neutrophil to Lymphocyte Count Ratio (NLCR) and blood cultures were done. Sensitivity, specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV) were calculated.

Results: Fifty neonates were included in this study. 23 neonates (46%) had positive blood cultures. Fourteen neonates (60.9%) of positive blood culture group were males (p value 0.013). Six neonates (26.1%) of positive bood culture group had maternal risk factors. Sensitivity, specificity, PPV, and NPV of RHSS were 73.9%, 100%, 100% and 81.8%, respectively. Sensitivity, specificity, PPV and NPV of NLCR are 65.2%, 70.4%, 65.2% and 70.4%, respectively, with cut-off point 2.495.

Conclusion: Rodwell Hematological Scoring System was superior to NLCR in the diagnosis of early onset neonatal sepsis.

Keywords: Neonatal Sepsis, Rodwell Hematological Scoring System, NLCR, Neonate.

Author’s Affiliation: 1- Department of Child Health, Sebelas Maret University – Dr. Moewardi Hospital Surakarta, Central Java, Indonesia

Correspondence: Pitra Sekarhandini, Email: pitrasekarhandini@gmail.com