The Value Of Platelete And Coagulation Parameters In The Diagosis Of Neonatal Late-Onset Sepsis

Objective:To investigate the value of platelet parameters and coagulation parameters in the diagnosis of neonatal late-onset sepsis.Method:A total of 315 neonates in a neonatal ward between January 2010 and December 2014 were divided into culture-proven sepsis group (n=115) and clinical sepsis goup (n=105), there were 95 hospitalized neonates with noninfectious diseases were enrolled as control group (n=95). The C-reactive protein (CRP), mean platelet volume (MPV), platelet distribution width, thrombocytocrit, activated partial thromboplastin time(APTT) and prothrombin time(PT) were measured for each neonate. The optimum cut-off value, AUC, sensitivity, specificity, positive predictive value, negative predictive value and likelihood ratio (LR) were calculated to analysis the value of a single or combined parameters in the diagnosis of neonatal sepsis. After analyzing the parameters with Logistic regression, we can screen diagnostic parameters for the neonatal late-onset sepsis and establish a mathematical model for diagnosis. Then drawing of ROC curves to analyze the diagnostic value of the new predictive parameter.Results:The values of CRP, MPV, PDW, APTT and PT were found to be increased in sepsis patients. ROC curve analysis showed that CRP and PT were better than APTT, PDW and MPV for the diagnosis of sepsis. Further, With the application of Regression of Binary Logistic, combining CRP, APTT and PT had a higher diagnosis value, with the AUC, sensitivity, specificity of 0.917,87.0% and 81.8%.Conclusions:These preliminary data show that diagnostic accuracy of CRP is superior to other parameters when measured at the time of suspected sepsis. It is inappropriate to use APTT, MPV and PDW for early diagnosis of sepsis, and PT had a good specificity and positive predictive value. Instead, the combined use of CRP, APTT and PT should be considered as it could help comprehensive utilization of clinical and laboratory data for the early and accurate diagnosis of neonatal sepsis.