Introduction Current hematology analysers can determine cell volume(V), conductivity for internal composition of cell(C) and light scatter for cytoplasmic granularity and nuclear structure(S) and standart deviations.
Method We investigated these parameters in secreening of neonatal sepsis beyond the first day of life. We used LH780 hematological analyzer(Beckman Coulter, Fullerton, CA). We combined these parameters with interleukin-6(IL-6) and C-reactive protein(CRP), and developed models to diagnose sepsis by Effective Modelling of Moleculer Activity(EMMA).
Results A total of 237 newborn, 61 proven sepsis, 108 clinical sepsis and 68 control, were enrolled the study. Mean neutrophil volume(MNV) and volume distribution width(VDW) were found to be statistically increased both in proven and clinical sepsis groups. We developed models using MNV, VDV, IL-6 and CRP. These models gave more sensitivity and specificity than usage of MNV, VDW, IL-6 and CRP alone.
Conclusion We suggest to use combination of MNV and VDW with markers such as CRP and IL-6, and use diagnostic models created by using EMMA including these markers.
Model 1: Sepsis= –1.17+0.015*[CRP]+0.009*[MNV].
Model 2: Sepsis= –1.35+0.0136*[CRP]+0.0074*[MNV]+0.0123* [VDW].
Model 3: Sepsis= –0.94+0.0043*[IL6]+0.011*[CRP]+0.0069*[MNV]
Table 2. Test results and models’ performance of sepsis group
Parameter Cut-off Sens Spec 95% Confidence Interval
MNV (au) >157.1 78.64 81.63 0.807 to 0.890
VDW (au) >37.4 59.71 77.55 0.687 to 0.789
IL6 (pg/mL) >18 81.76 92.65 0.869 to 0.945
CRP (mg/dL) >7.5 71.57 98.53 0.852 to 0.928
Model 1 >0.3099 88.73 92.65 0.921 to 0.975
Model 2 >0.3615 87.75 92.65 0.912 to 0.970
Model 3 >0.2429 95.86 91.18 0.950 to 0.992
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