EVALUATION OF THE SEPTIC SCORE IN NICU AT AHMAD MAHER TEACHING HOSPITAL | ||||
| Al-Azhar Journal of Pediatrics | ||||
| Article 9, Volume 23, Issue 1, January 2020, Page 795-810 PDF (189.65 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/azjp.2020.79329 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
| Raghdaa M. Ali; Manal El-Sayed; Omnia Salah El-Din | ||||
| Abstract | ||||
| Background: Neonatal sepsis is a life threatening yet treatable condition. Clinical features of sepsis are non-specific in neonates; a high index of suspicion is required for timely diagnosis. Non- infectious disorders may produce hematological changes similar to those seen with infections. The aim of the work: was to evaluate the items of the hematological septic score used in Ahmed Maher Teaching Hospital to predict neonatal sepsis. Patient and Methods: Data collected included; 1- history of predisposing factors. 2- Clinical criteria suggestive of sepsis 3- Hematological septic score from 0-7. 4- Blood culture results. The collecting data were analyzed. Significance of the clinical criteria was done by T-test, chi- square and Fischer`s exact test. Significance of each of individual hematological items was assessed by its sensitivity, specificity, positive predictive value and negative predicative value. Combination scores 2, 3, 4, 5 and 6 were also assessed in the same way. Results and discussion: The study was completed with 548 cases. Clinical signs that were statistically significantly associated with culture positive (proven cases) of neonatal septicemia were seizures (p = 0.0), irritability, lethargy and poor feeding (p<0.001), hypo or hyperthermia (p<0.02), respiratory symptoms (p<0.05) and (p<0.05). So these clinical characteristics could be used as predictive signs of neonatal sepsis with poor diagnostic value. The only individual hematological score that could be used to predict neonatal sepsis was I/T ratio > 0.2 that had sensitivity 71% and negative predictive value 86%. All other tests had poor sensitivity. Combination scores 2, 3, 4 and 5 had also very poor sensitivity values (28.6%, 92.8%, 53.3% and 53.3%) respectively. Only combination score 6 had a sensitivity of 84.2%. So, it could be considered as a predictor for diagnosis of neonatal sepsis. Conclusion and Recommendation: The hematological scoring system used in the neonatology department in Ahmad Maher Teaching Hospital was of limited value in early diagnosis of neonatal sepsis. New techniques should be included in the laboratory septic score used in Ahmad Maher Teaching Hospital. | ||||
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