New Diagnostic Possibilities for Early Onset Neonatal Sepsis: Red Cell Distribution Width to Platelet Ratio

Karabulut, Birol; Arcagök, Baran Cengiz

doi:10.1080/15513815.2019.1661051

Cited by 30 publications

(37 citation statements)

References 33 publications

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“…Increased RDW showed a significant association with blood culture positivity. A study from Karabulut and Arcagok [26] identified that RDW and red cell distribution width to platelet ratio (RPR) was higher in suspected and proven EONS compared to control group. They further suggested that raised RPR may be used for diagnosis of EONS.…”

Section: Discussionmentioning

confidence: 99%

Utility of Red Cell Distribution Width (RDW) In Diagnosis and Prognosis of Early-Onset Neonatal Sepsis in Term Neonates

et al. 2021

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Objective: To assess the increased Red Cell Distribution Width (RDW) in diagnosis and prognosis of early-onset neonatal sepsis in term neonates. Methods: In a prospective, observational study, we enrolled term neonates ( 37 weeks of gestation) clinically suspected for Early-Onset Neonatal Sepsis (EONS) (within 7 days of birth). A cut-off of 18% and above was taken to consider RDW as abnormal or increased. The primary outcome was to assess the relation of increased RDW with in-hospital mortality. The secondary outcome was to determine the diagnostic yield of increased RDW in culture-proven sepsis. Results: In 166 neonates, 60% were males. Increased RDW was seen in 42.42% of neonates and 15.75% of neonates had positive blood culture. Compared to normal RDW, in-hospital mortality was significantly higher in neonates with increased mortality (27.14% vs. 10.52%, respectively; p=0.006). Also, abnormal RDW was seen in 46.15% of neonates with positive blood culture compared to 35.25% of neonates with negative blood culture (p<0.0001). Thus, elevated RDW had a sensitivity of 44.4% and specificity of 57.97% in the diagnosis of EONS. Conclusion: Increased RDW can be a diagnostic as well as a prognostic marker in neonates with EONS. Such observation indicates it may serve as a simple and easily available marker for EONS in resource-limited settings. However, these findings need to be confirmed in a larger sample. Doi: 10.28991/SciMedJ-2021-0303-7 Full Text: PDF

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Section: Discussionmentioning

confidence: 99%

Utility of Red Cell Distribution Width (RDW) In Diagnosis and Prognosis of Early-Onset Neonatal Sepsis in Term Neonates

et al. 2021

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“…Similarly, the work of Karabulut and Arcagok showed that RPR was an available biomarker for the prediction of early-onset neonatal sepsis with an AUROC of 0.816. 34 However, no study has investigated the relationship between RPR and adult sepsis. So, our study was the first to explore the underlying connection between RPR and adult sepsis.…”

Section: Discussionmentioning

confidence: 99%

<p>The Association of Red Blood Cell Distribution Width to Platelet Count Ratio and 28-Day Mortality of Patients with Sepsis: A Retrospective Cohort Study</p>

Ge¹,

Lin²,

Zhang³

et al. 2020

TCRM

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Background: Sepsis is a life-threatening and inflammatory disease with high morbidity and mortality. Red blood cell distribution width to platelet count ratio (RPR) was known as an inflammatory biomarker and was related to poor outcomes of various diseases. Aim: This study was intended to explore the association between RPR and mortality of sepsis patients. Methods: A retrospective cohort study was undertaken in patients with sepsis, and the data were collected from a public database called Medical Information Mart for Intensive Care III (MIMIC-III). The primary outcome was 28-day mortality while the secondary outcomes were 90-day mortality and ICU mortality. Multivariable regression analyses, as well as interaction and stratified analyses, were conducted to investigate the relation between RPR and sepsis mortality. Results: In total, we enrolled 7531 patients with 1316 deaths. RPR was independently correlated with 28-day mortality (per 0.1 increase: HR=1.04; 95% CI 1.02-1.06), 90-day mortality (per 0.1 increase: HR=1.04; 95% CI 1.03-1.06) and ICU mortality (per 0.1 increase: OR=1.06; 95% CI 1.02-1.10). Twenty-eight-day survival was worse in the high RPR (≥0.134) group according to the Kaplan-Meier curve analyses (Log rank test, p<0.001). In stratified analyses, Sequential Organ Failure Assessment (SOFA) score and length of ICU stay had interactive effects with the high RPR (≥0.134) group on 28-day mortality. Conclusion: RPR is a novel biomarker that indicates poor prognosis of sepsis patients. Clinicians are required to pay more attention to those patients with high RPR.

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“…HLH is an entity featured by hyperinflammatory response and “cytokine storm.” In inflammation, pro‐inflammatory cytokines affect the survival of red blood cells in circulation, damage the red blood cell membrane, and cause larger and newer reticulocytes to enter the blood circulation, increasing the red blood cell distribution width (RDW) 31 . In addition, numerous inflammatory cytokines contribute to coagulation disorders, reduce platelet count, and overt disseminated intravascular coagulation 32 .…”

Section: Discussionmentioning

confidence: 99%

Diagnostic value of red blood cell distribution width, platelet distribution width, and red blood cell distribution width to platelet ratio in children with hemophagocytic lymphohistiocytosis

Bai

2021

Clinical Laboratory Analysis

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Background To investigate whether red blood cell distribution width (RDW), platelet distribution width (PDW), and red blood cell distribution width to platelet ratio (RPR) can serve as biomarkers to distinguish hemophagocytic lymphohistiocytosis (HLH) from sepsis in children. Methods This is a retrospective study, involving 71 HLH patients, 105 sepsis patients, and 88 normal controls from January 2018 to December 2019. RDW, PDW, and RPR values were obtained from peripheral blood samples before standard treatment. The clinical differential diagnostic values of RDW, PDW, and RPR were analyzed by receiver operating characteristic (ROC) curve. In addition, peripheral blood samples after treatment from HLH patients were also collected for the same analyses. Results RDW, PDW, and RPR levels of the HLH patients were significantly higher than those of sepsis and normal controls (p < 0.001). In ROC curve analysis of the RDW, PDW, and RPR for diagnosis of HLH, the area under the curve (AUC) could reach to 0.7799 (95% CI = 0.7113–0.8486), 0.7835 (95% CI = 0.7093–0.8577), and 0.9268 (95% CI = 0.8886–0.9649), respectively. When using the criteria of RDW >13.75, PDW >13.30, and RPR >0.08, the sensitivity was 76.06%, 67.61%, and 84.51%, while the specificity was 68.57%, 85.71%, and 87.62%, respectively. After treatment of HLH patients, PDW and RPR were significantly reduced (p < 0.001). Conclusions This study shows that RDW, PDW, and RPR, which can be easily and cheaply detected, are novel indicators for differential diagnosis of HLH. PDW and RPR are useful indices for monitoring the effects of treatment on HLH.

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New Diagnostic Possibilities for Early Onset Neonatal Sepsis: Red Cell Distribution Width to Platelet Ratio

Cited by 30 publications

References 33 publications

Utility of Red Cell Distribution Width (RDW) In Diagnosis and Prognosis of Early-Onset Neonatal Sepsis in Term Neonates

Utility of Red Cell Distribution Width (RDW) In Diagnosis and Prognosis of Early-Onset Neonatal Sepsis in Term Neonates

<p>The Association of Red Blood Cell Distribution Width to Platelet Count Ratio and 28-Day Mortality of Patients with Sepsis: A Retrospective Cohort Study</p>

Diagnostic value of red blood cell distribution width, platelet distribution width, and red blood cell distribution width to platelet ratio in children with hemophagocytic lymphohistiocytosis

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