Modified Hematological Sepsis Score in the Early Diagnosis of Neonatal Sepsis

Objective: To compare the diagnostic accuracy of modified hematological sepsis score (MHSS) with hematological sepsis score (HSS) in early diagnosis of neonatal sepsis taking blood culture as gold standard. Methodology: This cross-sectional validation study was done at the Neonatology Department, Children Hospital of Pakistan Institute of Medical Sciences, Islamabad from 1-01-2020 to 30-06-2020 after ethical approval. A total of 80 neonates admitted to the neonatal unit with clinical manifestations suggestive of sepsis or maternal risk factors were enrolled using nonprobability convenient sampling. Babies were assessed in consultation with the senior neonatologist. After informed written consent, their blood samples were sent to the laboratory for blood complete picture, peripheral film and blood culture. Both MHSS and HSS were calculated. Specificity, sensitivity, positive predictive value (PPV) and negative predictive value (NPV) of MHSS were compared with that of HSS taking blood culture as the gold standard. Results: Modified hematological sepsis score has a sensitivity and specificity of 84.21% and 75.41% respectively whereas its PPV and NPV are 51.6% and 93.8%. Compared to this, the hematological sepsis score has sensitivity, specificity, PPV and NPV of 78.9% and 67.21%, 42.6% and 91.11%, respectively. Conclusion: Modified hematological sepsis score has increased sensitivity and specificity in early diagnosis of neonatal sepsis. The diagnostic strength of the modified hematological sepsis score is superior to that of the hematological sepsis score.