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Role of systemic immune-inflammatory index in early diagnosis of sepsis in newborns with CHD

Published online by Cambridge University Press:  13 May 2022

Seda Aydogan Open the ORCID record for Seda Aydogan [Opens in a new window] ,
Dilek Dilli Open the ORCID record for Dilek Dilli [Opens in a new window] ,
Caganay Soysal ,
Hasan Akduman ,
Utku Arman Örün Open the ORCID record for Utku Arman Örün [Opens in a new window] ,
Mehmet Taşar Open the ORCID record for Mehmet Taşar [Opens in a new window] ,
Irfan Taşoglu  and
Ayşegül Zenciroglu
Seda Aydogan*
Affiliation:
Department of Neonatology, University of Health Sciences of Turkey, Dr. Sami Ulus Maternity and Children Training and Research Hospital, Ankara, Turkey
Dilek Dilli
Affiliation:
Department of Neonatology, University of Health Sciences of Turkey, Dr. Sami Ulus Maternity and Children Training and Research Hospital, Ankara, Turkey
Caganay Soysal
Affiliation:
Department of Obstetrics and Gynecology, University of Health Sciences of Turkey, Dr. Sami Ulus Maternity and Children Training and Research Hospital, Ankara, Turkey
Hasan Akduman
Affiliation:
Department of Neonatology, University of Health Sciences of Turkey, Dr. Sami Ulus Maternity and Children Training and Research Hospital, Ankara, Turkey
Utku Arman Örün
Affiliation:
Department of Pediatric Cardiology, University of Health Sciences of Turkey, Dr. Sami Ulus Maternity and Children Training and Research Hospital, Ankara, Turkey
Mehmet Taşar
Affiliation:
Department of Pediatric Cardiovascular Surgery, University of Health Sciences of Turkey, Dr. Sami Ulus Maternity and Children Training and Research Hospital, Ankara, Turkey
Irfan Taşoglu
Affiliation:
Department of Cardiovascular Surgery, University of Health Sciences of Turkey, Turkiye Yuksek Ihtisas Hospital, Ankara City Hospital, Ankara, Turkey
Ayşegül Zenciroglu
Affiliation:
Department of Neonatology, University of Health Sciences of Turkey, Dr. Sami Ulus Maternity and Children Training and Research Hospital, Ankara, Turkey
*
Author for correspondence: Seda Aydogan, MD, Dr. Sami Ulus Maternity and Children Research and Training Hospital, Ankara, Turkey. Yenidoğan Kliniği, Beştepeler mahallesi, Ankara/Turkey. Tel: 00 90 312 4123208. E-mail: [email protected].
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Abstract

Objective:

Congenital heart diseases (CHD) are the most common causes of birth defects that have increased the risk of infections. Neonatal sepsis is a life-threatening condition and early diagnosis can be life-saving. We aimed to evaluate the potential role of the systemic immune-inflammatory index in the early diagnosis of neonatal sepsis.

Methods:

A retrospective cohort study was conducted on 166 newborns with a diagnosis of neonatal sepsis who were admitted to our hospital with CHD between January 2017 and June 2021. Haematological indices including neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, and systemic immune-inflammatory index were calculated for all patients at the time of diagnosis of neonatal sepsis (sepsis). The sepsis values of these indices were compared with the admission values (pre-sepsis) of the patients.

Results:

The mean gestational age and birth weight of the patients were 38.36 ± 1.42 weeks and 3057.75 ± 484.68 g. It was found that absolute neutrophil count, systemic immune-inflammatory index, neutrophil/lymphocyte ratio, but not platelet/lymphocyte ratio were significantly increased at the time of sepsis. The receiver operating characteristic curve showed that systemic immune-inflammatory index, neutrophil/lymphocyte ratio, and absolute neutrophil count have predictive ability to define neonatal sepsis among newborns with CHD. The systemic immune-inflammatory index produced an area under the curve receiver operating characteristic curve of 0.76 (70% sensitivity, 70.5% specificity). To discriminate neonatal sepsis, the cut-off values of systemic immune-inflammatory index, neutrophil/lymphocyte ratio, and absolute neutrophil count were 517.19, 2.62, and 9210/mm3, respectively.

Conclusion:

As an easily accessible and reliable indicator, systemic immune-inflammatory index may be used in combination with the other parameters in the early diagnosis of neonatal sepsis.

Keywords

Congenital heart diseaseneonatal sepsisneutrophil/lymphocyte ratioplatelet/lymphocyte ratiosystemic immune-inflammatory index
Type
Original Article
Information
Cardiology in the Young , Volume 32 , Issue 11 , November 2022 , pp. 1826 - 1832
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Copyright
© The Author(s), 2022. Published by Cambridge University Press

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References

Hoffman, J, Kaplan, S. The incidence of congenital heart disease. J Am Coll Cardiol 2002; 39: 1890–1900.CrossRefGoogle ScholarPubMed
Satar, M, Arısoy, AE, Çelik, İH. Turkish Neonatal Society guideline on neonatal infections—Diagnosis and treatment. Turk Arch Pediat 2018; 53: S88–S100.CrossRefGoogle ScholarPubMed
Brocklehurst, P, Farrell, B, King, A, et al. Treatment of neonatal sepsis with intravenous immune globulin. N Engl J Med 2011; 365: 1201–1211.Google ScholarPubMed
Russell, AB, Kumar, R. Early onset neonatal sepsis: diagnostic dilemmas and practical management. Arch Dis Child-FETAL 2015; 100: 350–F354.CrossRefGoogle Scholar
Tong, YS, Tan, J, Zhou, XL, Song, YQ, Song, YJ. Systemic immune-inflammation index predicting chemoradiation resistance and poor outcome in patients with stage III non-small cell lung cancer. J Transl Med 2017; 15: 1–10, 2017.CrossRefGoogle ScholarPubMed
Xue, G, Gan, X, Wu, Z, et al. Novel serological biomarkers for inflammation in predicting disease severity in patients with COVID-19. Int Immunopharmacol 2020; 89: 107065.CrossRefGoogle ScholarPubMed
Haque, KN. Definitions of bloodstream infection in the newborn. Pediatr Crit Care Med 2005; 6: 45–S49.CrossRefGoogle ScholarPubMed
Aydogan, S, Akduman, H, Dilli, D, et al. The role of thiol-disulfide homeostasis in neonatal sepsis. J Matern Fetal Neonatal Med 2021; 34: 1522–1528.CrossRefGoogle ScholarPubMed
Fluss, R, Faraggi, D, Reiser, B. Estimation of the Youden Index and its associated cutoff point. Biom J Math Methods Biosci 2005; 47: 458–472. doi: 10.1002/bimj.200410135.Google ScholarPubMed
Manandhar, SR, Basnet, R. Micro-erythrocyte sedimentation rate in neonatal sepsis of a tertiary hospital: a descriptive cross-sectional study. J Nepal Med Assoc 2020; 58: 377–382.CrossRefGoogle ScholarPubMed
Hornik, CP, Fort, P, Clark, RH, et al. Early and late onset sepsis in very-low-birth-weight infants from a large group of neonatal intensive care units. Early Hum Dev 2012; 88: S69–S74.CrossRefGoogle ScholarPubMed
Garges, HP, Moody, MA, Cotten, CM, et al. Neonatal meningitis: what is the correlation among cerebrospinal fluid cultures, blood cultures, and cerebrospinal fluid parameters? Pediatrics 2006; 117: 1094–1100.CrossRefGoogle ScholarPubMed
Wynn, JL. Defining neonatal sepsis. Curr Opin Pediatr 2016; 28: 135–140.CrossRefGoogle ScholarPubMed
Li, YJ, Chen, SQ, Lin, YY, et al. Identification and antimicrobial resistance of pathogens in neonatal septicemia in China: a meta-analysis. Int J Infect Dis 2018; 71: 89–93. DOI 10.1016/j.ijid.2018.04.794.CrossRefGoogle ScholarPubMed
Chacha, F, Mirambo, MM, Mushi, MF, et al. Utility of qualitative C- reactive protein assay and white blood cells counts in the diagnosis of neonatal septicaemia at Bugando Medical Centre, Tanzania. BMC Pediatr 2014; 14: 248.CrossRefGoogle ScholarPubMed
Can, E, Hamilcikan, Ş., Can, C. The value of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio for detecting early-onset neonatal sepsis. J Pediatr Hematol Oncol 2018; 40: 229–232.CrossRefGoogle ScholarPubMed
Arcagok, BC, Karabulut, B. Platelet to lymphocyte ratio in neonates: a predictor of early-onset neonatal sepsis. Mediterr J Hematol Infect Dis 2019; 11: 2019055.Google ScholarPubMed
Ree, IM, Fustolo-Gunnink, SF, Bekker, V, Fijnvandraat, KJ, Steggerda, SJ, Lopriore, E. Thrombocytopenia in neonatal sepsis: incidence, severity and risk factors. PloS One 2017; 12: e0185581.CrossRefGoogle ScholarPubMed
Manzoni, P. Hematologic aspects of early and lat-onset sepsis in preterm infants. Clin Perinatol 2015; 42: 587–595. DOI 10.1016/j.clp.2015.04.012.CrossRefGoogle ScholarPubMed
Ashour, R, Waael, Z, Rashwan, NI, Fayed, HM. The pattern of systemic inflammatory markers response in neonatal sepsis. SVU Int J Med Sci 2022; 5: 252–260.Google Scholar
Zhang, S, Diao, J, Qi, C, et al. Predictive value of neutrophil to lymphocyte ratio in patients with acute ST segment elevation myocardial infarction after percutaneous coronary intervention: a meta-analysis. BMC Cardiovasc Disord 2018; 18: 75.CrossRefGoogle ScholarPubMed
Chen, J, Zhai, E, Yuan, Y,et al. Systemic immune-inflammation index for predicting prognosis of colorectal cancer. World J Gastroenterol.2017 2017; 23: 6261.CrossRefGoogle ScholarPubMed
Mannaerts, D, Heyvaert, S, De Cordt, C, Macken, C, Loos, C, Jacquemyn, Y. Are neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and/or mean platelet volume (MPV) clinically useful as predictive parameters for preeclampsia? J Matern Fetal Neonatal Med 2019; 32: 1412–1419.CrossRefGoogle ScholarPubMed
Yang, YL, Wu, CH, Hsu, PF, et al. Systemic immune-inflammation index (SII) predicted clinical outcome in patients with coronary artery disease. Eur J Clin Invest 2020; 50: e13230.CrossRefGoogle ScholarPubMed
Hu, B, Yang, XR, Xu, Y, et al. Systemic immune-inflammation index predicts prognosis of patients after curative resection for hepatocellular carcinoma. Clin Cancer Res 2014; 20: 6212–6222.CrossRefGoogle ScholarPubMed
Yang, R, Chang, Q, Meng, X, Gao, N, Wang, W. Prognostic value of systemic immune-inflammation index in cancer: a meta-analysis. J Cancer 2018; 9: 3295–3302.CrossRefGoogle ScholarPubMed
Wang, Q, Zhu, SR, Huang, XP, Liu, XQ, Liu, JB, Tian, G. Prognostic value of systemic immune-inflammation index in patients with urinary system cancers: a meta-analysis. Eur Rev Med Pharmacol 2021; 25: 1302–1310.Google ScholarPubMed
Ayca, B, Akin, F, Celik, O, et al. Neutrophil to lymphocyte ratio is related to stent thrombosis and high mortality in patients with acute myocardial infarction. Angiology 2015; 66: 545–552. DOI 10.1177/0003319714542997.CrossRefGoogle ScholarPubMed
Liu, J, Ao, W, Zhou, J, Luo, P, Wang, Q, Xiang, D. The correlation between PLR-NLR and prognosis in acute myocardial infarction. Am J Transl Res 2021 May 15; 13: 4892–4899.Google Scholar