Evaluation of modified hematological scoring system and platelet indices in diagnosing neonatal sepsis—A cross-sectional study

The gold standard for identifying neonatal sepsis is blood culture. However, there are a few drawbacks: Getting results takes time and requires a complex procedure; also, it frequently yields false-positive or false-negative findings. Platelet indices and the modified hematological scoring system (mHSS) aid in the precise diagnosis of newborn sepsis. This study was conducted to assess the diagnostic value of platelet indices and mHSS in the diagnosis of neonatal sepsis separately and in combination. This cross-sectional study was performed on 104 neonates having clinical suspicion of sepsis. Various parameters of mHSS and platelet indices were studied, and results were compared with blood culture results. The statistical analysis was conducted by calculating sensitivity, specificity positive predictive value (PPV), and negative predictive value (NPV).The study showed out of 104 neonates, 45 (43.26%) neonates had positive blood culture. After analyzing the data, mHSS ≥3 had sensitivity of 75.56% and specificity of 88.14%, platelet count <150000/microliter had sensitivity of 86.67% and specificity of 77.97%, mean platelet volume (MPV) 9.5fL had sensitivity of 93.33% and specificity of 69.49%, and at a cut-off value of >18%, and platelet distribution width (PDW) had sensitivity of 82.22% and specificity of 91.53%. On combining mHSS and platelet indices, that is, total platelet count, MPV, and PDW, the sensitivity was 64.44% with a specificity of 61.02%. The mHSS and platelet indices can be used in early diagnosis of neonatal sepsis. These are simple, quick, cost-effective, and readily available tools with high sensitivity and specificity. So, these can be very well used as a screening test for early diagnosis of neonatal sepsis.