Evaluation of Ema, Töllner and Rodwell scores in the diagnosis of neonatal sepsis

Abstract

Introduction: There are no specific signs, symptoms and rapid laboratory tests to definitively diagnose sepsis in the neonatal period. This makes it difficult to diagnose sepsis in newborns in a timely manner and initiate appropriate treatment, or causes babies without sepsis to receive unnecessary antibiotics. Purpose: Therefore, in this study, we planned to investigate the clinical adequacy and reliability of EMA (European Medicines Agency), Töllner and Rodwell hematological scoring in the early diagnosis of neonatal sepsis. Method: EMA, Töllner and Rodwell hematological scoring was performed on each patient. Complete blood count, peripheral smear, C-reactive protein, procalcitonin, blood gas and blood sugar values of newborn babies with suspected sepsis were recorded, blood culture, urine culture and cerebrospinal fluid examination and cultures taken when necessary were evaluated. Using statistical analysis, the 'Positive Expected Value and Negative Expected Values' ratios of the scores were obtained, and the performance results were examined. Results: 95 newborns with a preliminary clinical diagnosis of sepsis were included in the study. These babies were divided into two groups: clinical (n:71) and proven sepsis (n:24) according to blood culture results. Positive and negative predictive values of scoring systems in definitive sepsis diagnosis; for EMA respectively; 21.5%, 56.3% for Töllner; It was determined as 31.3%, 77.8%, and 100%, 77.8% for Rodwell. Conclusion: Our study showed that clinician opinion and standard laboratory tests are limited in the diagnosis of neonatal sepsis, and Rodwell hematological scoring is more prominent in recognizing proven sepsis compared to the other two scores .