HEMATOLOGICAL AND BIOCHEMICAL PREDICTORS OF MORTALITY IN NEONATAL SEPSIS

Abstract

Introduction: This study was conducted to study the factors predicting mortality in neonatal sepsis, so that focused attention is paid to them, with an aim to bring down the mortality rates in neonates admitted with sepsis.

Methods: This study was a prospective observational study. Neonates who were admitted with a suspicion of sepsis or in whom sepsis was suspected anytime during hospital stay were evaluated and included in study when sepsis was confirmed. Complete blood counts (CBC), C-reactive protein (CRP) levels, chest X-ray and cultures of blood, urine and CSF were collected. Additional data like blood sugar, serum calcium, serum creatinine, serum electrolytes and coagulogram were also collected. Different haematological and biochemical parameters were compared between septic babies who survived and those who expired. GraphPad Instat statistical software was used for analysis.

Results: Over the study period, 196 patients were evaluated for sepsis on the basis of clinical features. 120 patients satisfied our case definition and were allotted to the sepsis group and included in the study. Out of these 120 patients, 28 patients expired. Blood cultures were positive in 76 babies. Thirty six babies had meningitis and 22 babies had pneumonia. Thrombocytopenia, leucopenia, neutropenia, coagulopathy and hyponatremia had a statistically significant relationship with mortality. There was no statistically significant difference in mortality of patients with or without hypernatremia. Similar insignificant difference was seen with other parameters like acute kidney injury (AKI), seizures, meningitis, hypoglycemia and high CRP titers. On logistic regression analysis, birth weight < 2500 gm, neutropenia and coagulopathy were significant independent predictors of mortality in neonates with sepsis.