title: Are Global Coagulation and Platelet Parameters Useful Markers for Predicting Late-Onset Neonatal Sepsis?.
abstract: BACKGROUND
  Diagnosis of neonatal sepsis is difficult because of the nonspecific nature of the clinical presentation. Inflammation and coagulation can activate each other. Coagulation activation can occur in the early phase of sepsis. The main purposes of this study were to investigate the value of platelet parameters and coagulation parameters in predicting neonatal sepsis.
  
  
  METHODS
  The study included 650 patients: 490, Group I (330 proven and 160 clinical sepsis cases), and 160, Group II (control group). Platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW), thrombocytocrit, prothrombin time (PT), and activated partial thromboplastin time (APTT) were measured. The parameters were determined before diagnosis of sepsis. Receiver-operating characteristic (ROC) curves were analyzed to determine the optimal thresholds. The optimum cutoff value, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated for each potential marker.
  
  
  RESULTS
  The MPV, PDW, PT, and CRP values were found to be increased while PLT decreased significantly in sepsis patients. ROC curve analysis showed that PT and PLT were better than PDW and MPV for the diagnosis of sepsis. Further, combining PT (17.85 s) and CRP (8.5 mg/L) can enhance the diagnostic accuracy of sepsis, with a sensitivity, specificity, PPV, and NPV of 77.9, 83.1, 58.2, and 92.6%, respectively.
  
  
  CONCLUSIONS
  PT has a potential to be an additional indicator for neonatal sepsis, the combined use of PT and other markers such as CRP should be considered in the early diagnosis of neonatal sepsis.
authors.forename: Qi
authors.initials: Q
authors.lastname: Lu
authors.forename: Hongmei
authors.initials: H
authors.lastname: Duan
authors.forename: Jialin
authors.initials: J
authors.lastname: Yu
authors.forename: Yao
authors.initials: Y
authors.lastname: Yao
mesh_terms: D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D001777:Blood Coagulation; D001792:Blood Platelets / Q000378:metabolism*; D002097:C-Reactive Protein / Q000032:analysis; D002681:China; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000097:blood / Q000175:diagnosis*; D018836:Inflammation Mediators / Q000097:blood; D008297:Male; D010976:Platelet Count; D011237:Predictive Value of Tests; D011517:Prothrombin Time; D012372:ROC Curve; D015203:Reproducibility of Results; D012189:Retrospective Studies; D018805:Sepsis / Q000097:blood / Q000175:diagnosis*
chemical_list: D015415:Biomarkers; D018836:Inflammation Mediators; D002097:C-Reactive Protein