Evaluation of Red Blood Cell Distribution Width-Platelet Ratio as an Early Predictor of Late-Onset Sepsis in Preterm Infants

Introduction: Late-onset sepsis (LOS) is a major cause of death and neurodevelopmental impairment in preterm infants. In this study, our aim was to review the role of red cell distribution width to platelet ratio (RPR) to predict LOS in preterm infants. Materials and Methods: Preterm infants with ≤366/7 gestational weeks who were admitted to the neonatal intensive care (NICU) between January 2018 and 2020 were accepted in this observational cohort study. LOS group had culture-proven LOS and the control group with no LOS during their NICU stay. Complete blood cell parameters were recorded on the day of culture growth in the groups. The study cohort was classified into two groups according to the type of the growing microorganism and the RPR levels were then evaluated in intra- and inter-group analyses. Results: Eighty -five infants were included in the final analysis. RPR values were significantly higher in the LOS group (p<0.001) In the subgoup analyses, RDW and RPR values were significantly higher in the group with Gram-negative sepsis (p<0.001). The sensitivity and specificity of an RPR cutoff value of 0.17% were found to be 60% and 92% (p<0.001), respectively for predicting LOS. Conclusion: This study defined that RPR is a practical and useful marker to predict LOS in preterm infants. Future prospective studies with large study groups are needed to evaluate the role of RPR in the prediction of late-onset sepsis. red cell platelet