Figure 1
Figure 2
Figure 3
Figure 4
ROC analysis results for NLR, LMR, PLR, and peripheral blood count in patients with neonatal sepsis
| Variable | Sensitivity (%) | Specificity (%) | LHOR | AUC ROC | 95% Confidence interval | Cut-off | P |
|---|---|---|---|---|---|---|---|
| Neonatal sepsis | |||||||
| WBC (×109/L) | 10.5 | 98.7 | 8.1 | 0.700 | 0.61–0.79 | ≥ 23.4 | <0.001* |
| Neutrophils (×109/L) | 15.8 | 98.7 | 12.1 | 0.739 | 0.65–0.83 | ≥14.2 | <0.001* |
| Monocytes (×109/L) | 21.1 | 96.1 | 5.4 | 0. 613 | 0.51–0.71 | ≥2.04 | 0.025* |
| NLR | 8.8 | 98.7 | 6.7 | 0.729 | 0.64–0.82 | ≥4.79 | <0.001* |
| LMR | 5.3 | 98.7 | 4.05 | 0.353 | 0.26–0.45 | ≥10.9 | 0.004* |
| EOS | |||||||
| WBC (×109/L) | 40 | 96.1 | 10.26 | 0.861 | 0.77–0.95 | ≥20.4 | <0.001* |
| Neutrophils (×109/L) | 40 | 98.7 | 30.8 | 0.902 | 0.84–0.97 | ≥14.0 | <0.001* |
| Monocytes (×109/L) | 10 | 98.7 | 7.7 | 0.725 | 0.59–0.86 | ≥2.77 | 0.002* |
| Platelets (×109/L) | 5 | 94.8 | 0.96 | 0.236 | 0.12–0.35 | ≥526 | <0.001* |
| NLR | 15 | 98.7 | 11.6 | 0.845 | 0.76–0.93 | ≥4.79 | <0.001* |
| LMR | 100 | 2.6 | 1.02 | 0.295 | 0.18–0.41 | ≥1.24 | 0.005* |
| PLR | 80 | 7.8 | 0.86 | 0.268 | 0.15–0.39 | ≥37.7 | 0.001* |
| LOS | |||||||
| Neutrophils (×109/L) | 5.4 | 98.7 | 4.16 | 0.651 | 0.54–0.76 | ≥14.5 | 0.009* |
| NLR | 5.4 | 98.7 | 4.16 | 0.667 | 0.56–0.77 | ≥4.94 | 0.004* |
| LMR | 8.1 | 98.7 | 6.24 | 0.384 | 0.26–0.51 | ≥10.9 | 0.045* |
Comparison of NLR, LMR, PLR, and peripheral complete blood count parameters between the neonatal patient group and healthy neonatal control group
| Neonatal patient group (n = 155) Median ± IQR (percentiles: 25th–75th) | |||||||
|---|---|---|---|---|---|---|---|
| Neonatal sepsis (n = 57) | Pneumonia (n = 44) | UTI (n = 18) | Focal infection (n = 12) | Viral infection (n = 9) | Fever (no infection) (n = 15) | Healthy neonatal control group (n = 77) | |
| WBC (×109/L) | 14.2 ± 8.82 (10.22–19.03)* | 11.10 ± 5.59 (8.48–13.57) | 11.57 ± 5.53 (8.87–14.40) | 13.85 ± 11.8 (9.24–21.05) | 10.2 ± 4.10 (8.75–12.85) | 13.90 ± 6.80 (10.9–17.7)* | 10.12 ± 4.84 (8.36–13.20) |
| Lymphocytes (×109/L) | 3.97 ± 2.58 (2.92–5.50) | 4.98 ± 2.76 (3.46–6.22) | 4.66 ± 2.68 (3.52–6.20) | 5.26 ± 3.58 (3.57–7.15) | 4.56 ± 2.30 (2.92–5.21) | 3.73 ± 1.30 (3.54–4.84) | 4.53 ± 1.52 (3.87–5.39) |
| Neutrophils (×109/L) | 7.61 ± 8.35 (3.85–12.20)* | 3.33 ± 3.63 (2.32–5.95) | 4.46 ± 4.20 (2.37–6.58) | 4.0 ± 9.24 (2.13–11.37) | 3.94 ± 2.26 (3.01–5.26) | 8.41 ± 5.90 (4.60–10.5)* | 3.38 ± 3.13 (2.29–5.42) |
| Monocytes (×109/L) | 1.41 ± 1.06 (0.83–1.89)* | 1.28 ± 1.21 (0.82–2.03)* | 1.39 ± 0.94 (0.83–1.77) | 1.75 ± 1.17 (1.13–2.30)* | 1.64 ± 1.77 (1.15–2.92)* | 1.05 ± 0.94 (0.81–1.75) | 1.21 ± 0.67 (1.21–1.49) |
| Platelets (×109/L) | 297.0 ± 171.0 (205.5–376.5) | 373.5 ± 151.5 (298.25–449.75) | 356.0 ± 223.5 (221.0–444.5) | 326.0 ± 179.75 (236.25–416.0) | 368.0 ± 137.5 (274.5–412.0) | 320.0 ± 152.0 (273.0–425.0) | 321.0 ± 162.0 (282.5–444.5) |
| NLR | 1.95 ± 2.12 (0.90–3.03)* | 0.69 ± 0.93 (0.46–1.39) | 0.97 ± 0.87 (0.48–1.35) | 1.12 ± 1.34 (0.33–1.67) | 1.02 ± 1.32 (0.57–1.89) | 1.80 ± 1.75 (1.13–2.88)* | 0.81 ± 0.87 (0.49–1.36) |
| LMR | 2.79 ± 2.03 (2.32–4.35)* | 3.31 ± 3.42 (2.63–6.05) | 4.28 ± 4.02 (2.37–6.38) | 2.65 ± 3.30 (2.17–5.46) | 1.60 ± 3.71 (1.36–5.08)* | 3.52 ± 3.32 (2.72–6.05) | 3.97 ± 3.09 (2.95–6.05) |
| PLR | 69.25 ± 48.96 (50.66–99.63) | 72.6 ± 52.29 (54.74–107.02) | 62.78 ± 58.90 (49.99–108.90) | 59.77 ± 33.91 (48.10–82.01) | 77.31 ± 66.21 (70.6–136.82) | 78.40 ± 50.73 (62.14–112.87) | 77.90 ± 38.76 (60.40–99.16) |
| CRP (< 0.5 mg per 100 mL, normal) | 0.58 ± 1.69 (0.10–1.79) | 0.10 ± 0.54 (0.03–0.56) | 0.09 ± 1.10 (0.02–1.12) | 0.45 ± 13.64 (0.05–13.69) | 0.33 ± 0.59 (0.09–0.68) | 1.5 ± 3.11 (0.74–3.85) | – |
| Hospital stay (d) | 9.0 ± 3.0 (–) | 9.0 ± 3.0 (–) | 10.0 ± 4.0 (–) | 10.0 ± 4.75 (–) | 6.0 ± 3.0 (–) | 8.0 ± 3.0 (–) | – |
Comparison of NLR, LMR, PLR, and peripheral complete blood count parameters between the neonatal sepsis group and healthy neonates control group
| Neonatal sepsis group (n = 57) | Healthy neonate group (n = 77) | P† | P‡ | ||
|---|---|---|---|---|---|
| EOS (n = 20) | LOS (n = 37) | ||||
| WBC (×109/L) | 18.8 ± 11.27 (13.75–25.02)* | 13.1 ± 6.57 (8.98–15.56) | 10.12 ± 4.84 (8.36–13.20) | <0.001* | 0.51 |
| Lymphocytes (×109/L) | 4.79 ± 1.81 (3.81–5.62) | 3.84 ± 2.75 (2.75–5.49) | 4.53 ± 1.52 (3.87–5.39) | 0.614 | 0.57 |
| Neutrophils (×109/L) | 11.87 ± 7.98 (7.46–15.45)* | 5.41 ± 7.28 (3.05–10.33)* | 3.38 ± 3.13 (2.29–5.42) | <0.001* | 0.009# |
| Monocytes (×109/L) | 1.68 ± 0.99 (1.16–2.15)* | 1.35 ± 0.86 (0.74–1.59) | 1.21 ± 0.67 (1.21–1.49) | 0.002* | 0.36 |
| Platelets (×109/L) | 252.5 ± 113.0 (191.5–304.5)* | 338.0 ± 157.5 (241.0–398.5) | 321.0 ± 162.0 (282.5–444.5) | <0.001* | 0.52 |
| NLR | 2.39 ± 1.76 (1.57–3.33)* | 1.49 ± 2.18 (0.68–2.86)* | 0.81 ± 0.87 (0.49–1.36) | <0.001* | 0.004# |
| LMR | 2.74 ± 1.64 (2.41–4.05)* | 2.84 ± 3.33 (2.21–5.54)* | 3.97 ± 3.09 (2.95–6.05) | 0.005* | 0.045# |
| PLR | 55.50 ± 34.87 (39.92–74.78)* | 81.29 ± 51.27 (63.59–114.86) | 77.90 ± 38.76 (60.40–99.16) | 0.001* | 0.48 |
Patient demographic characteristics
| Characteristic | Neonatal patient group (n = 155) | Healthy neonates (n = 77) | P |
|---|---|---|---|
| Sex, n (%) | Female 65 (41.9) | Female 34 (44.2) | 0.77† |
| Male 90 (58.1) | Male 43 (55.8) | ||
| Form of birth, n (%) | Normal vaginal route 97 (62.6) | Normal vaginal route 41 (53.2) | 0.20† |
| Cesarean section 58 (37.4) | Cesarean section 36 (46.8) | ||
| Gestational weeks¶ | 38.8 ± 1.13 (37–42) | 38.7 ± 1.06 (37–41) | 0.63‡ |
| Birth weight (g)¶ | 3,397 ± 468 (1,830–4,850) | 3,362 ± 372 (2,400–4,050) | 0.57§ |
| Postnatal age (d)¶ | 14.4 ± 9.6 (1–28) | 12.2 ± 8.5 (1–28) | 0.14‡ |