Study of Efficacy of Haematological Scoring System in Neonatal Sepsis

Background: Neonatal sepsis is a clinical syndrome represented by signs and symptoms of infection, with or without associated bacteremia, in first 28 days of life. It is one of the commonest and most important cause for morbidity and mortality of neonates in developing countries like India. The gold standard test for sepsis is blood culture. But culture based diagnosis has its own constraints as it is time demanding with an assay time of up to 48-72 hours. In 1988, Rodwell gave a haematological scoring system for prompt diagnosis of neonatal sepsis. It covers numerous simple, bedside, cheap but reliable laboratory tests. Aim: To study the haematological parameters including the changes in the peripheral blood smears of neonates clinically suspicious of having sepsis. Objectives: To categorise haematological findings according to Rodwell haematological scoring system and to correlate the haematological score with blood culture. Methods: This was a two year prospective study conducted from august 2022 to august 2024 at Department of Pathology, Jhalawar Medical College, Jhalawar, Rajasthan. Total 130 neonates clinically suspicious of neonatal sepsis were included in this study. Statistical correlation between Rodwell’s HSS and blood culture was obtained using Chi square test. Results: Out of total 130 cases, 71 neonates (54.62%) had a haematological score of ≥4 and 59 neonates (45.38%) had a haematological score <4. Rodwell’s HSS achieved sensitivity of 95.0%, specificity 63.3%, positive predictive value 53.5% and negative predictive value 96.6%. The diagnostic accuracy of Rodwell’s HSS was 73.07%. Conclusion: When all the haematological parameters are used in combination as in Rodwell’s HSS, the diagnostic accuracy is high. Because of its high sensitivity when HSS score ≥4 is used as a cut off for the presence of sepsis, HSS can be used as a useful screening tool against neonatal sepsis. Thus, Rodwell’s haematological scoring system can aid in giving timely cure, shorten the hospital stay, reduce mortality and minimize the possibility of emergence of resistant organisms due to improper administration of antibiotics.