The Clinical Significance Of Changes In Red Blood Cell Distribution Width And Rdw-to-platelet Ratio In Late Premature Early-onset Sepsis

Objective:To search the track and clinical significance of red blood cell distribution width,red blood cell distribution width to platelet ratio and other relevant indices in late premature early-onset sepsis,as well as to explore meaningful biological indicators for the diagnosis or the evaluation of neonatal septic diseases.Methods:In this retrospective study,all cases were collected in the range of October2010 to September 2018 from files in NICU(Neonatal Intensive Care Unit),a department in Yijishan Hospital of Wannan Medical College,in which infants whose gestational age at birth from34~0/7/7 to 36~6/7/7 weeks were discharged and were diagnosed neonatal early-onset sepsis(EOS)definitely.Among these files,80 neonatal sepsis children are listed as experimental group.Correspondingly,30 non-sepsis cases are regarded as control group.Record basic information on children’s gestational age,gender,delivery mode and birth weight.Data about hemoglobin,hematocrit,red blood cell distribution width(RDW),white blood cell,platelet count,procalcitonin,C-reactive protein,mean corpuscular volume and RDW-to-platelet ratio(RPR)were collected the day after birth,taken on the same day as the blood cultures were recorded.Statistical analysis was used to indicate the correlations between RDW and basic information in light of the clinical data.Likewise,the predictive power of different variables was assessed by receiver operating characteristic curve.Discuss possible change regularity of RDW,RPR and whether they could be a constructive guideline in EOS or not.Results:1.In this study,2 groups showed significant differences regarding gestational age,delivery ways and birth weight(P<0.05).However,there was no significant difference in sex(P>0.05).2.RDW,white blood cell count,RPR,CRP,PCT level were significantly higher in sepsis group,whereas the platelet count were significantly lower.A comparison between non-sepsis group showed significant differences in CRP,PCT,PLT,WBC,RPR(P<0.05).No significant differences were found in PDW,Hb,MCV,Hct value.3.The correlations of RDW with the other laboratory parameters were evaluated with Pearson correlation coefficient,which revealed a significant negative correlation with gestational age(r=-0.446,P<0.05).On the other hand,no correlation was detected between RDW and gender,delivery mode,birth weight,Hct MCV,PCT,WBC,PLT,CRP and hemoglobin concentration.4.Red cell distribution width had an area under the curve(AUC)of 0.598;95%confidence interval(95%CI)0.500-0.691;positive predictive value,negative predictive value;+likelihood ratio;-likelihood ratio was 95.5%,33.0%,7.88 and 0.76respectively.At a cutoff level of 16.95%,RDW had a sensitivity of 26.25%and a specificity of 96.67%for diagnosis of EOS.Platelet distribution width had an area under the curve(AUC)of 0.525;95%confidence interval(95%CI)0.414-0.609;cut-off value,sensitivity,specificity,positive predictive value,negative predictive value;+likelihood ratio;-likelihood ratio was 12.05%,38.75%,76.67%,81.6%,31.9%,1.66 and 0.80 respectively.RPR had an area under the curve(AUC)of 0.722;95%confidence interval(95%CI)0.622-0.798;positive predictive value,negative predictive value;+likelihood ratio;-likelihood ratio was 91.8%,42.6%,4.22 and 0.50respectively.At a cutoff level of 0.073,RPR had a sensitivity of 56.25%and a specificity of 86.67%for diagnosis of EOS.Conclusion:1.RDW in late preterm infants was negatively correlated with gestational age and was not correlated with gender,birth weight,mode of delivery,and anemia.2.Value of RDW of late premature infants was elevated in inflammatory diseases.3.RDW and RPR can be used for the auxiliary diagnosis of EOS in late preterm infants,and RPR has better sensitivity and specificity than RDW.