Clinical utility of the Platelet-to-neutrophil ratio in differentiating sepsis from neonatal pneumonia: an observational study

In some cases, neonates with pneumonia can develop sepsis. The timely and accurate diagnosis of sepsis due to neonatal pneumonia poses a challenge for many clinicians. Therefore, this study aimed to evaluate the potential of the platelet-to-neutrophil ratio (PNR), as an early biomarker for clinically differentiating neonatal sepsis among pneumonia cases. We performed a cross-sectional analysis of clinical and laboratory data collected from 1,103 patients with neonatal pneumonia [773 with pneumonia and 330 with pneumonia and sepsis (PS)]. The PS group had a lower PNR than the pneumonia group. Further analysis revealed that the incidence of PS was significantly higher in the low PNR group than in the high PNR group (43.9% vs. 15.9%, <i>p</i> &lt; 0.01). Multivariate logistic regression analysis revealed that the PNR was an independent risk factor for sepsis in neonatal pneumonia. Receiver operating characteristic curve analysis demonstrated that the PNR has good efficacy in diagnosing neonatal patients with PS (area under curve = 0.76, 95% confidence interval: 0.73–0.80, <i>p</i> &lt; 0.001). PNR can serve as an early biomarker for differentiating neonatal sepsis among pneumonia cases. Despite its potential, the PNR requires validation in multicenter studies.