Selimovic et al developed a predictive score for identifying a neonate with early-onset sepsis. The authors are from the University Clinical Center at Tuzla in Bosnia and Herzegovina.
Patient selection: neonate, evaluated for the first time <= 72 hours after birth
Exclusions: major congenital anomaly, inborn error of metabolism, hemolytic jaundice, respiratory distress syndrome related to prematurity, receipt of antibiotic therapy prior to blood culture, born outside of clinic
Parameters:
(1) total white blood cell count in 10^9/L
(2) ratio of immature to total WBC
(3) ratio of immature to mature WBC (where mature = total minus immature)
(4) C-reactive protein (CRP) in mg/L
predictive score =
= (0.01 * (WBC multiplier)) + (5.7 * (ratio of immature to total WBC)) - (2.9 * (ratio of immature to mature)) + (0.01 * (CRP))
Interpretation:
• minimum score: 0
• maximum score: around 0.8
• A value >= 0.503 was used to identify an infant with early-onset neonatal sepsis.
Performance:
• The sensitivity at the cut-off was 73% and specificity 89% with area under the ROC curve of 0.87.
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