Prognostic value of initial antithrombin levels in neonatal sepsis.
OBJECTIVE
We determined whether initial antithrombin (AT) levels help in diagnosis and prognosis of neonatal sepsis.


METHODS
Sepsis was diagnosed according to clinical and laboratory findings and positive culture results in 34 of the 54 newborns who presented to the hospital with suspected sepsis. Between AT levels and hematological parameters (fibrinogen levels, prothrombin time (PT), activated partial thromboplastin time (aPTT) and liver function tests), these were correlated each other and with outcome of the babies.


RESULTS
Initial AT and fibrinogen levels were significantly lower in newborns with sepsis compared to control (P < 0.05). Initial AT levels were lower in the ones who developed disseminated intravascular coagulation (DIC) compared to those without DIC (P < 0.05). Initial AT levels were significantly lower in newborns who died as compared to survivors (P < 0.05). Sensitivity of AT was highest at 15 mg/dL for prognosis in neonatal sepsis (sensitivity:92.3%, specificity:61.9%, positive predictive value : 61.9 %; negative predictive value: 61.9%;).


CONCLUSIONS
Lower initial AT levels in neonatal sepsis are associated with a severe disease and increased mortality. It may be useful in predicting clinical outcome in neonatal sepsis.
Ersoy
Betul
B
Department of Pediatrics, Celal Bayar University, School of Medicine, Manisa, Turkey. betul_e@hotmail.com
Nehir
Hakan
H
Altinoz
Serdar
S
Yilmaz
Ozge
O
Dundar
Pinar Erbay
PE
Aydogan
Aysel
A
D000991:Antithrombins / Q000378:metabolism*; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D016905:Gram-Negative Bacterial Infections / Q000097:blood* / Q000175:diagnosis; D016908:Gram-Positive Bacterial Infections / Q000097:blood* / Q000175:diagnosis; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011237:Predictive Value of Tests; D011379:Prognosis; D018805:Sepsis / Q000097:blood* / Q000175:diagnosis* / Q000401:mortality