Document Detail


Hematologic scoring system in early diagnosis of sepsis in neutropenic newborns.
MedLine Citation:
PMID:  8327296     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The hematologic profiles of 1000 newborns were prospectively examined to identify infants with neutropenia (N = 170) according to the system of Manroe et al. (J Pediatr 1979;95:89-98) and to evaluate a hematologic scoring system (Rodwell et al. J Pediatr 1988;112:761-7) as a screening test for sepsis. Neutropenia was more commonly of noninfectious than infectious origin (83.5% vs. 16.5%; P < 0.001). On the initial test a positive screen (scores > or = 3) identified 26 of 28 infants with sepsis or probable infection (sensitivity 93%; specificity 82%; positive and negative predictive values 50 and 98%, respectively). Corresponding values for an elevated immature:total neutrophil ratio were 100, 75, 43 and 100%. Overall mortality with neutropenia was 15% and was higher with an infectious than a noninfectious etiology (39% vs. 11%, P < 0.001) despite early antibiotic therapy. The combination of a neutrophil count < or = 500/mm3 and scores > or = 3 or an elevated immature:total neutrophil ratio identified a poor prognostic group: 67% (8 of 12) and 70% (7 of 10) infants, respectively, with these findings died, 6 in the infected group. The hematologic scoring system or immature:total neutrophil ratio in combination with the degree of neutropenia provides valuable diagnostic and prognostic information which could be applied to identification of possible candidates for granulocyte transfusions or other experimental treatments.
Authors:
R L Rodwell; K M Taylor; D I Tudehope; P H Gray
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Pediatric infectious disease journal     Volume:  12     ISSN:  0891-3668     ISO Abbreviation:  Pediatr. Infect. Dis. J.     Publication Date:  1993 May 
Date Detail:
Created Date:  1993-08-12     Completed Date:  1993-08-12     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8701858     Medline TA:  Pediatr Infect Dis J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  372-6     Citation Subset:  IM    
Affiliation:
Hematology Department Mater Misericordiae Hospitals, South Brisbane, Australia.
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MeSH Terms
Descriptor/Qualifier:
Bacterial Infections / complications,  diagnosis*,  mortality
Chi-Square Distribution
Evaluation Studies as Topic
False Positive Reactions
Hematologic Tests*
Humans
Infant, Newborn
Infant, Premature, Diseases / blood,  diagnosis,  etiology*
Leukocyte Count
Neutropenia / blood,  etiology*,  mortality
Neutrophils
Platelet Count
Predictive Value of Tests
Prospective Studies

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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