Yenidoğan sepsisinde tam kan sayımı parametrelerinin tanısal değeri

Objective: This study was planned to determine whether complete blood count parameters and scores based on complete blood count can be used as a diagnostic marker in neonatal sepsis. Methods: This retrospective study included 70 patients with neonatal sepsis (Group 1) and 65 healthy neonates (Group 2) with similar age, sex, birth weight, and gestational age. The demographic data, blood culture results, clinical and laboratory findings were obtained from the medical records. Scores based on complete blood count such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), eosinophil-to-lymphocyte ratio (ELR), basophil-to-lymphocyte ratio (BLR) and monocyte-to-lymphocyte ratio (MLR) were calculated by dividing the number of neutrophils, platelets, eosinophils, basophils and monocytes by the number of lymphocytes, respectively. Results: There were no significant differences between the groups in terms of demographic characteristics such as age, gender, birth weight, type of delivery and gestational week. C-reactive protein level was significantly higher in the neonatal sepsis group (p 0.05). While NLR was significantly higher (2.19±1.39 vs 1.44±1.07, p<0.001), ELR was significantly lower (0.08±0.07 vs 0.09±0.05, p=0.007) in neonatal sepsis group. NLR was positively correlated while ELR, lymphocyte, platelet, eosinophil and monocyte counts were negatively correlated with CRP (p<0.05). According to the results of ROC curve analysis, CRP, NLR, ELR, neutrophil, lymphocyte, platelet, eosinophil and monocyte counts were significant parameters for the diagnosis of neonatal sepsis. Cut-off values were 6.09 mg/L for CRP (sensitivity 88.57%, specificity 100%, AUC: 0.964, p <0.001), 1.01 for NLR (sensitivity 78.57%, specificity 63.08%, AUC: 0.727, p <0.001, 0.079 for ELR (sensitivity 64.29%, specificity 56.92%, AUC: 0.634, p = 0.007), 4.66x109/L for neutrophil count (sensitivity 68.57%, specificity 61.54%, AUC: 0.683, p<0.001), 4.33x109/L for lymphocyte count (sensitivity 65.71%, specificity 60.00%, AUC: 0.668, p=0.001), 259.00x109/L for platelet count (sensitivity 62.86%, specificity 58.46%, AUC: 0.659, p=0.001), 0.27x109/L for neutrophil count (sensitivity 61.42%, specificity 69.23%, AUC: 0.708, p<0.001) and 1.33x109/L for monocyte count (sensitivity 62.86%, specificity 56.92%, AUC: 0.647, p=0.003) Conclusion: Although their sensitivities and specificities lower than CRP; NLR, ELR, neutrophil, lymphocyte, platelet, eosinophil and monocyte counts can be accepted as adjunctive data that contribute to the diagnosis of neonatal sepsis. In particular, NLR seems to be the most useful complete blood count parameter in the diagnosis of neonatal sepsis with the highest sensitivity and specificity

Diagnostic value of complete blood count parameters in neonatal sepsis

Amaç: Bu çalışma tam kan sayımı parametrelerinin ve tam kan sayımına dayalı skorların yenidoğan sepsisinde tanısal biyo-belirteç olarak kullanılıp kullanılamayacaklarını belirlemek amacıyla planlanmıştır. Yöntemler: Retrospektif olarak planlanan bu çalışmaya, yenidoğan sepsisi tanısı almış 70 hasta (Grup 1) ve hasta grubuyla benzer yaş, cinsiyet, doğum ağırlığı ve doğum haftasında olan 65 sağlıklı yenidoğan (Grup 2) olarak çalışmaya alındı. Demografik veriler, kan kültürü sonuçları, klinik ve laboratuvar bulguları tıbbi kayıtlardan elde edildi. Nötrofil/lenfosit oranı (NLO), trombosit/lenfosit oranı (TLO), eozinofil/lenfosit oranı (ELO), bazofil/lenfosit oranı (BLO) ve monosit/lenfosit oranı (MLO) gibi tam kan sayımına dayalı skorlar, sırasıyla nötrofil, trombosit, eozinofil, bazofil ve monosit sayısının lenfosit sayısına bölünmesiyle hesaplandı. Bulgular: Yaş, cinsiyet, doğum tartısı, doğum şekli ve gebelik haftası gibi demografik özellikler bakımdan gruplar arasında fark yoktu (p>0,05). C-reaktif protein düzeyi yenidoğan sepsisi grubunda anlamlı olarak yüksekti (p0,05). NLO yenidoğan sepsisi grubunda anlamlı olarak yüksek iken (2,19±1,39 vs 1,44±1,07, p 0.05). While NLR was significantly higher (2.19±1.39 vs 1.44±1.07, p<0.001), ELR was significantly lower (0.08±0.07 vs 0.09±0.05, p=0.007) in neonatal sepsis group. NLR was positively correlated while ELR, lymphocyte, platelet, eosinophil and monocyte counts were negatively correlated with CRP (p<0.05). According to the results of ROC curve analysis, CRP, NLR, ELR, neutrophil, lymphocyte, platelet, eosinophil and monocyte counts were significant parameters for the diagnosis of neonatal sepsis. Cut-off values were 6.09 mg/L for CRP (sensitivity 88.57%, specificity 100%, AUC: 0.964, p <0.001), 1.01 for NLR (sensitivity 78.57%, specificity 63.08%, AUC: 0.727, p <0.001, 0.079 for ELR (sensitivity 64.29%, specificity 56.92%, AUC: 0.634, p = 0.007), 4.66x109/L for neutrophil count (sensitivity 68.57%, specificity 61.54%, AUC: 0.683, p<0.001), 4.33x109/L for lymphocyte count (sensitivity 65.71%, specificity 60.00%, AUC: 0.668, p=0.001), 259.00x109/L for platelet count (sensitivity 62.86%, specificity 58.46%, AUC: 0.659, p=0.001), 0.27x109/L for neutrophil count (sensitivity 61.42%, specificity 69.23%, AUC: 0.708, p<0.001) and 1.33x109/L for monocyte count (sensitivity 62.86%, specificity 56.92%, AUC: 0.647, p=0.003) Conclusion: Although their sensitivities and specificities lower than CRP; NLR, ELR, neutrophil, lymphocyte, platelet, eosinophil and monocyte counts can be accepted as adjunctive data that contribute to the diagnosis of neonatal sepsis. In particular, NLR seems to be the most useful complete blood count parameter in the diagnosis of neonatal sepsis with the highest sensitivity and specificity

WITH ANTROPOMETRIC MEASUREMENT VALUES OF THE SUSPENDANT SLEEP APNE SYNDROME INVESTIGATION OF THE RELATIONSHIP BETWEEN THE APNE-HYPOPLINE INDEX

Bu çalışmada Tıkayıcı Uyku Apne Sendrom'lu (TUAS) hastalara ait antropometrik ölçüm değerleri ile Apne-Hipopne İndeksi (AHİ) arasındaki ilişkinin incelenmesi amaçlandı. Çalışmaya 110 hasta (77 erkek, 33 kadın) dahil edildi. Hastaların yaş, boy, vücut ağırlığı, beden kitle indeksi (BKİ), boyun çevresi (BÇ) ve tiromental açı ölçümleri kaydedildi. Ayrıca hastalarda Epworth uykululuk skorları (EUS), Mallampati ve Cormack-Lehane sınıflandırması yapıldı. Verilerin analizinde One-Way ANOVA, Kruskal-Wallis, Pearson ve Spearman korelasyon katsayısı testleri kullanıldı. Boyun Çevresi ölçümleri (normal grupta 39.46±3.55 cm, hafif TUAS'lı grupta 40.91±4.23 cm, orta TUAS'lı grupta 42.32±3.48 cm ve ağır TUAS'lı grupta 43.8±4.65 cm) ve Mallampati sınıflandırması (normal grupta2.41±0.70, hafif TUAS'lı grupta 2.58±0.69, orta TUAS'lı grupta 3.25±0.79 ve ağır TUAS'lı grupta 2.90±0.64) grupları arasında istatistiksel olarak anlamlı fark bulundu (sırayla p=0.001 ve p=0.000). AHİ ile BÇ (r=0.385, p=0.000), EUS (r=0.215, p=0.025) ve Mallampati sınıflandırması (r=0.308, p=0.001) arasında ilişki bulundu. Yaptığımız çalışma sonucunda; TUAS tanısının konulmasında BÇ uzunluğu, Mallampati sınıflandırması ve EUS değerlerinin kullanılabilirliği gösterilmiştir. TUAS tanısında bu değerlerin belirleyici bir faktör olabileceği düşünülmektedir.In this study, we aimed to estimate the relationship between anthropometric measures and Apnea-Hypopnea Index (AHI) values of the patients who were evaluated with polisomnography (PSG) and diagnosed as obstructive sleep apnea syndrome (OSAS). 110 patients (77 male, 33 female) were included in this study. Age, height, weight, body mass index (BMI), neck circumference (NC) and thyromental angle were recorded. Epworth Sleepiness Scores(ESS) were determined. Mallampati classification and Cormack and Lehane classification were also noted. Data were analyzed with One-Way ANOVA, Kruskal-Wallis, Pearson and Spearman Correlation Coefficient tests. Between neck circumference (39.46&plusmn;3.55 cm in the normal group, 40.91&plusmn;4.23 cm in the mild OSAS group, 42.32&plusmn;3.48 cm in the moderate OSAS group and 43.8&plusmn;4.65 cm in the severe OSAS group) and Mallampati classification groups (2.41&plusmn;0.70 in the normal group, 2.58&plusmn;0.69 23 in the mild OSAS group, 3.25&plusmn;0.79 in the moderate OSAS group and 2.90&plusmn;0.64 in the severe OSAS group) was a statistically significant difference (respectively p=0.001 and p=0.000). AHI was correlated with neck circumference (r=0.385, p=0.000), ESS (r=0.215, p=0.025) and Mallampati classification (r=0.308, p=0.001). In our study; neck circumference, Mallampati classification and Epworth Sleepiness Score values were shown to be useful determinants in diagnosing OSAS. It is thought that these values may be a predictive factor in the diagnosis of OSAS