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

Purpose Neonatal sepsis has wide variations of clinical presentations, which may not reflect the severity of the disease. Our objective was to investigate the prognostic value of the hematological scoring system (HSS), red cell distribution width (RDW), mean platelet volume (MPV), and platelet distribution width (PDW) in neonatal sepsis at the time of admission to the neonatal ICU.Patients and methods The study included two groups: the neonatal sepsis group which included 64 neonates with neonatal sepsis and the control group which included 60 neonates with sex, gestational, and postnatal ages matched with the previous group. RDW, MPV, and PDW were measured for all included neonates. Score for Neonatal Acute Physiology-II score and HSS were determined for the sepsis group within 12 h of admission to the neonatal ICU.Results RDW, MPV, and PDW were significantly higher in the sepsis group than the control group (P<0.0001). RDW, MPV, PDW, and HSS were not significantly different between neonates with culture-proven sepsis and those with probable sepsis (P>0.05). But on comparing their levels in survivors with the nonsurvivors, all of them were significantly higher in the nonsurvivors (P<0.05), except for HSS (P=0.4). RDW was the most sensitive hematological marker studied to predict mortality, as RDW and Score for Neonatal Acute Physiology-II score more than or equal to 40 had the same sensitivity of 77.8%, followed by MPV (61.1%), and then PDW (50%). Meanwhile, the MPV was the most specific (88.1%). Receiver operating characteristic curve analysis for HSS was not of statistical significance (P>0.05).Conclusion RDW is the most sensitive hematological marker to predict mortality in neonatal sepsis, followed by MPV and PDW. HSS is still a diagnostic rather than a prognostic score.