Role of Hematological Scoring System and its Significance in Early Diagnosis of Neonatal Sepsis

This is the authors' abstract. We don't add key points for this paper.

A BSTRACT Background: Neonatal sepsis is a major cause of morbidity and mortality in newborns, especially in low- and middle-income countries. In addition to mortality, it leads to serious complications such as seizures, neurodevelopmental disorders, sensorineural hearing loss, and ocular disturbances. Early diagnosis allows timely treatment and prevention of life-threatening outcomes. However, its early clinical features are often nonspecific, making accurate diagnosis difficult. This study aimed to assess the applicability of the hematological scoring system (HSS) in early diagnosis of neonatal sepsis and its correlation with C-reactive protein (CRP) and blood culture. Methods: This observational cross-sectional study included 100 consecutive cases of neonates admitted to the Sick Newborn Care Unit (SNCU) and Neonatal Intensive Care Unit (NICU) of a tertiary care hospital with clinical suspicion of sepsis. Hematological parameters, CRP, and blood cultures were evaluated, with blood culture considered the diagnostic gold standard. A hematological score ≥3 was interpreted as positive. Results: Among 100 neonates, 38% had culture-proven sepsis. The Immature-to-Total Polymorphonuclear neutrophil (PMN) (I: T) and Immature-to-Mature PMN (I: M) ratios showed the highest specificity but lower sensitivity, followed by immature polymorphonuclear (PMN) count and total leukocyte count. Degenerative changes in PMNs and total PMN count demonstrated higher sensitivity. I: T and I: M ratios showed the highest positive predictive value, followed by immature PMN count. Overall, HSS score ≥3 was more reliable than individual parameters. Conclusion: HSS is a rapid, simple, and cost-effective method for diagnosing suspected neonatal sepsis. It also provides a useful guideline for judicious antibiotic use.