Usefulness of Haematological Scoring System in Early Diagnosis of Neonatal Sepsis

Background: Neonatal sepsis is one of the major causes of morbidity and mortality of the new born, especially in developing countries. The major concerns of the clinicians are its non-specific presentation and unavailability of tests with a high predictive value. Therefore, the need is for an infallible test that can be easily performed, quick, simple and cost-effective. Objectives: To assess the reliability of Haematological scoring system in diagnosis of suspected neonatal sepsis at early stage. Materials and Methods: A total of 84 suspected cases of neonatal sepsis were included in this prospective cross-sectional study carried out in Khulna City Medical College Hospital during the period from July 2021 to June 2022. The peripheral blood smears from all 84 patients were analysed using HSS of Rowell et al by pathologists. HSS assigns a score of 1 for each of seven findings significantly associated with sepsis such as total leukocyte count, total polymorphonuclear neutrophil count, elevated immature PMN count, elevated immature: total PMN ratio, Immature: mature PMN ratio >0.3, platelet count <150000/cmm, and pronounced degenerative or toxic changes in PMNs. The HSS score of >5 was interpreted as sepsis, blood culture was done as gold standard for diagnosis of sepsis. Each haematological parameter was assessed for its individual performance and sensitivity, specificity, positive and negative predictive values were calculated. Results: Among the total 84 suspected cases, 20 cases were diagnosed neonatal sepsis, (23.8%), 31 cases had probable infection (36.9%), and 33 cases were normal (39.3%). Elevated immature: total PMN count ratio (>0.2) and Immature: Mature PMN ratio (>0.3) were the most sensitive and specific parameter for sepsis. It was also seen that with increasing score, the likelihood of sepsis also increases. Conclusion: The sensitivities and specificities of the various parameters of HSS were found to be satisfactorily significant in identifying ........