Objectives Early detection and aggressive treatment for neonatal sepsis is important for survival. This study investigated the significance of calculated delata neutrophil index (DNI) as a prognostic factor of severe sepsis.
Methods In a retrospective study, 72 neonates admitted to Severance Children’s Hospital and Gangnam Severance Hospital between Jan 2009. to Dec 2010, were recruited. Twenty four infants were diagnosed as blood proven sepsis, and 48 neonates matched for gestation were recruited as controls. Among 24 infants, 5 patients died within 7 days.
Results In univariate analysis, mean DNI (at diagnosis, after 24hr and 72hr), C-reactive protein and WBC for sepsis group were significantly higher, and neutrophil count, platelet count were significantly lower than control groups. Among sepsis group, mean DNI at diagnosis (6.5 vs 3.7 p=0.048), DNI at 72hr (8.4 vs 2.1, p=0.003) CRP at 72hr (67 vs 21, p=0.010) and platelet count (85000 vs 141000, p=0.008) for patient with mortality were significantly increased compared to the patients with survival. Other demographic factors are not remarkable. In multiple logistic regression analysis, mortality in sepsis significantly correlated with DNI at 72hr, odds ratio (OR) 1.47, 95% confidence interval (CI) 1.1–5.6 (p=0.032), and with platelet, OR 0.93, 95%CI 0.51–0.99 (p=0.014). In ROC analysis, provided DNI at 72hr at cut off value of 12% predicted mortality with 81% sensitivity and 87% specificity.
Conclusion DNI can have implications for sepsis and may be valuable to assess the prognosis of patient with sepsis.