Hostname: page-component-76d6cb85b7-xh428 Total loading time: 0 Render date: 2026-07-10T19:10:31.867Z Has data issue: false hasContentIssue false
  • English
  • Français

Role of systemic immune-inflammatory index in early diagnosis of sepsis in newborns with CHD

Published online by Cambridge University Press:  13 May 2022

Seda Aydogan Open the ORCID record for Seda Aydogan [Opens in a new window] ,
Dilek Dilli Open the ORCID record for Dilek Dilli [Opens in a new window] ,
Caganay Soysal ,
Hasan Akduman ,
Utku Arman Örün Open the ORCID record for Utku Arman Örün [Opens in a new window] ,
Mehmet Taşar Open the ORCID record for Mehmet Taşar [Opens in a new window] ,
Irfan Taşoglu  and
Ayşegül Zenciroglu
Seda Aydogan*
Affiliation:
Department of Neonatology, University of Health Sciences of Turkey, Dr. Sami Ulus Maternity and Children Training and Research Hospital, Ankara, Turkey
Dilek Dilli
Affiliation:
Department of Neonatology, University of Health Sciences of Turkey, Dr. Sami Ulus Maternity and Children Training and Research Hospital, Ankara, Turkey
Caganay Soysal
Affiliation:
Department of Obstetrics and Gynecology, University of Health Sciences of Turkey, Dr. Sami Ulus Maternity and Children Training and Research Hospital, Ankara, Turkey
Hasan Akduman
Affiliation:
Department of Neonatology, University of Health Sciences of Turkey, Dr. Sami Ulus Maternity and Children Training and Research Hospital, Ankara, Turkey
Utku Arman Örün
Affiliation:
Department of Pediatric Cardiology, University of Health Sciences of Turkey, Dr. Sami Ulus Maternity and Children Training and Research Hospital, Ankara, Turkey
Mehmet Taşar
Affiliation:
Department of Pediatric Cardiovascular Surgery, University of Health Sciences of Turkey, Dr. Sami Ulus Maternity and Children Training and Research Hospital, Ankara, Turkey
Irfan Taşoglu
Affiliation:
Department of Cardiovascular Surgery, University of Health Sciences of Turkey, Turkiye Yuksek Ihtisas Hospital, Ankara City Hospital, Ankara, Turkey
Ayşegül Zenciroglu
Affiliation:
Department of Neonatology, University of Health Sciences of Turkey, Dr. Sami Ulus Maternity and Children Training and Research Hospital, Ankara, Turkey
*
Author for correspondence: Seda Aydogan, MD, Dr. Sami Ulus Maternity and Children Research and Training Hospital, Ankara, Turkey. Yenidoğan Kliniği, Beştepeler mahallesi, Ankara/Turkey. Tel: 00 90 312 4123208. E-mail: drsedakunt@gmail.com.
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

Congenital heart diseases (CHD) are the most common causes of birth defects that have increased the risk of infections. Neonatal sepsis is a life-threatening condition and early diagnosis can be life-saving. We aimed to evaluate the potential role of the systemic immune-inflammatory index in the early diagnosis of neonatal sepsis.

Methods:

A retrospective cohort study was conducted on 166 newborns with a diagnosis of neonatal sepsis who were admitted to our hospital with CHD between January 2017 and June 2021. Haematological indices including neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, and systemic immune-inflammatory index were calculated for all patients at the time of diagnosis of neonatal sepsis (sepsis). The sepsis values of these indices were compared with the admission values (pre-sepsis) of the patients.

Results:

The mean gestational age and birth weight of the patients were 38.36 ± 1.42 weeks and 3057.75 ± 484.68 g. It was found that absolute neutrophil count, systemic immune-inflammatory index, neutrophil/lymphocyte ratio, but not platelet/lymphocyte ratio were significantly increased at the time of sepsis. The receiver operating characteristic curve showed that systemic immune-inflammatory index, neutrophil/lymphocyte ratio, and absolute neutrophil count have predictive ability to define neonatal sepsis among newborns with CHD. The systemic immune-inflammatory index produced an area under the curve receiver operating characteristic curve of 0.76 (70% sensitivity, 70.5% specificity). To discriminate neonatal sepsis, the cut-off values of systemic immune-inflammatory index, neutrophil/lymphocyte ratio, and absolute neutrophil count were 517.19, 2.62, and 9210/mm3, respectively.

Conclusion:

As an easily accessible and reliable indicator, systemic immune-inflammatory index may be used in combination with the other parameters in the early diagnosis of neonatal sepsis.

Keywords

Congenital heart diseaseneonatal sepsisneutrophil/lymphocyte ratioplatelet/lymphocyte ratiosystemic immune-inflammatory index

Information

Type
Original Article
Information
Cardiology in the Young , Volume 32 , Issue 11 , November 2022 , pp. 1826 - 1832
Check for updates
Copyright
© The Author(s), 2022. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

Hoffman, J, Kaplan, S. The incidence of congenital heart disease. J Am Coll Cardiol 2002; 39: 1890–1900.CrossRefGoogle ScholarPubMed
Satar, M, Arısoy, AE, Çelik, İH. Turkish Neonatal Society guideline on neonatal infections—Diagnosis and treatment. Turk Arch Pediat 2018; 53: S88–S100.CrossRefGoogle ScholarPubMed
Brocklehurst, P, Farrell, B, King, A, et al. Treatment of neonatal sepsis with intravenous immune globulin. N Engl J Med 2011; 365: 1201–1211.Google ScholarPubMed
Russell, AB, Kumar, R. Early onset neonatal sepsis: diagnostic dilemmas and practical management. Arch Dis Child-FETAL 2015; 100: 350–F354.CrossRefGoogle Scholar
Tong, YS, Tan, J, Zhou, XL, Song, YQ, Song, YJ. Systemic immune-inflammation index predicting chemoradiation resistance and poor outcome in patients with stage III non-small cell lung cancer. J Transl Med 2017; 15: 1–10, 2017.CrossRefGoogle ScholarPubMed
Xue, G, Gan, X, Wu, Z, et al. Novel serological biomarkers for inflammation in predicting disease severity in patients with COVID-19. Int Immunopharmacol 2020; 89: 107065.CrossRefGoogle ScholarPubMed
Haque, KN. Definitions of bloodstream infection in the newborn. Pediatr Crit Care Med 2005; 6: 45–S49.CrossRefGoogle ScholarPubMed
Aydogan, S, Akduman, H, Dilli, D, et al. The role of thiol-disulfide homeostasis in neonatal sepsis. J Matern Fetal Neonatal Med 2021; 34: 1522–1528.CrossRefGoogle ScholarPubMed
Fluss, R, Faraggi, D, Reiser, B. Estimation of the Youden Index and its associated cutoff point. Biom J Math Methods Biosci 2005; 47: 458–472. doi: 10.1002/bimj.200410135.Google ScholarPubMed
Manandhar, SR, Basnet, R. Micro-erythrocyte sedimentation rate in neonatal sepsis of a tertiary hospital: a descriptive cross-sectional study. J Nepal Med Assoc 2020; 58: 377–382.CrossRefGoogle ScholarPubMed
Hornik, CP, Fort, P, Clark, RH, et al. Early and late onset sepsis in very-low-birth-weight infants from a large group of neonatal intensive care units. Early Hum Dev 2012; 88: S69–S74.CrossRefGoogle ScholarPubMed
Garges, HP, Moody, MA, Cotten, CM, et al. Neonatal meningitis: what is the correlation among cerebrospinal fluid cultures, blood cultures, and cerebrospinal fluid parameters? Pediatrics 2006; 117: 1094–1100.CrossRefGoogle ScholarPubMed
Wynn, JL. Defining neonatal sepsis. Curr Opin Pediatr 2016; 28: 135–140.CrossRefGoogle ScholarPubMed
Li, YJ, Chen, SQ, Lin, YY, et al. Identification and antimicrobial resistance of pathogens in neonatal septicemia in China: a meta-analysis. Int J Infect Dis 2018; 71: 89–93. DOI 10.1016/j.ijid.2018.04.794.CrossRefGoogle ScholarPubMed
Chacha, F, Mirambo, MM, Mushi, MF, et al. Utility of qualitative C- reactive protein assay and white blood cells counts in the diagnosis of neonatal septicaemia at Bugando Medical Centre, Tanzania. BMC Pediatr 2014; 14: 248.CrossRefGoogle ScholarPubMed
Can, E, Hamilcikan, Ş., Can, C. The value of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio for detecting early-onset neonatal sepsis. J Pediatr Hematol Oncol 2018; 40: 229–232.CrossRefGoogle ScholarPubMed
Arcagok, BC, Karabulut, B. Platelet to lymphocyte ratio in neonates: a predictor of early-onset neonatal sepsis. Mediterr J Hematol Infect Dis 2019; 11: 2019055.Google ScholarPubMed
Ree, IM, Fustolo-Gunnink, SF, Bekker, V, Fijnvandraat, KJ, Steggerda, SJ, Lopriore, E. Thrombocytopenia in neonatal sepsis: incidence, severity and risk factors. PloS One 2017; 12: e0185581.CrossRefGoogle ScholarPubMed
Manzoni, P. Hematologic aspects of early and lat-onset sepsis in preterm infants. Clin Perinatol 2015; 42: 587–595. DOI 10.1016/j.clp.2015.04.012.CrossRefGoogle ScholarPubMed
Ashour, R, Waael, Z, Rashwan, NI, Fayed, HM. The pattern of systemic inflammatory markers response in neonatal sepsis. SVU Int J Med Sci 2022; 5: 252–260.Google Scholar
Zhang, S, Diao, J, Qi, C, et al. Predictive value of neutrophil to lymphocyte ratio in patients with acute ST segment elevation myocardial infarction after percutaneous coronary intervention: a meta-analysis. BMC Cardiovasc Disord 2018; 18: 75.CrossRefGoogle ScholarPubMed
Chen, J, Zhai, E, Yuan, Y,et al. Systemic immune-inflammation index for predicting prognosis of colorectal cancer. World J Gastroenterol.2017 2017; 23: 6261.CrossRefGoogle ScholarPubMed
Mannaerts, D, Heyvaert, S, De Cordt, C, Macken, C, Loos, C, Jacquemyn, Y. Are neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and/or mean platelet volume (MPV) clinically useful as predictive parameters for preeclampsia? J Matern Fetal Neonatal Med 2019; 32: 1412–1419.CrossRefGoogle ScholarPubMed
Yang, YL, Wu, CH, Hsu, PF, et al. Systemic immune-inflammation index (SII) predicted clinical outcome in patients with coronary artery disease. Eur J Clin Invest 2020; 50: e13230.CrossRefGoogle ScholarPubMed
Hu, B, Yang, XR, Xu, Y, et al. Systemic immune-inflammation index predicts prognosis of patients after curative resection for hepatocellular carcinoma. Clin Cancer Res 2014; 20: 6212–6222.CrossRefGoogle ScholarPubMed
Yang, R, Chang, Q, Meng, X, Gao, N, Wang, W. Prognostic value of systemic immune-inflammation index in cancer: a meta-analysis. J Cancer 2018; 9: 3295–3302.CrossRefGoogle ScholarPubMed
Wang, Q, Zhu, SR, Huang, XP, Liu, XQ, Liu, JB, Tian, G. Prognostic value of systemic immune-inflammation index in patients with urinary system cancers: a meta-analysis. Eur Rev Med Pharmacol 2021; 25: 1302–1310.Google ScholarPubMed
Ayca, B, Akin, F, Celik, O, et al. Neutrophil to lymphocyte ratio is related to stent thrombosis and high mortality in patients with acute myocardial infarction. Angiology 2015; 66: 545–552. DOI 10.1177/0003319714542997.CrossRefGoogle ScholarPubMed
Liu, J, Ao, W, Zhou, J, Luo, P, Wang, Q, Xiang, D. The correlation between PLR-NLR and prognosis in acute myocardial infarction. Am J Transl Res 2021 May 15; 13: 4892–4899.Google Scholar