Hematological and inflammatory diagnostic criteria and their prognostic importance in infants with sepsis

We aimed to highlight the importance of plasma raftlin levels in the diagnosis and prognosis of sepsis in addition to the classical diagnostic criteria in neonatal sepsis. This study was conducted as a single-center case-control study at SANKO University Faculty of Medicine Hospital between January 2023 and January 2024. It included 60 patients diagnosed with late neonatal sepsis who were admitted to the Neonatal Intensive Care Unit and born at 37 weeks of gestation or later, along with a control group of 35 neonates. The patient group was divided into two groups based on their sepsis diagnosis values on day 0 and day 7. Additionally, 15 patients who died during the study were included as the exitus group, forming a total of four groups. The median CRP levels were 52,9 mg/L in the patient (day 0) group, 1,2 mg/L in the control group, and 120,3 mg/L in the exitus group, with a statistically significant difference found among the three groups (p<0,001). For procalcitonin levels, the median values were 2,50 mcg/L in the patient (day 0) group, 0,03 mcg/L in the control group, and 9,60 mcg/L in the exitus group, with a statistically significant difference among the three groups (p<0,001). The mean raftlin levels were 394,8 ± 99,4 ng/ml in the patient (day 0) group, 71,6 ± 21,1 ng/ml in the control group, and 584,4 ± 73,4 ng/ml in the exitus group, with a statistically significant difference among the three groups (p<0,001). The mean pSOFA Sepsis Scores were 9,6 ± 3,2 in the patient (day 0) group, 2,3 ± 1,6 in the patient (day 7) group, and 17,9 ± 2,2 in the exitus group, with a statistically significant difference among the three groups (p<0,001). The mean Phoenix Sepsis Scores were 6,1 ± 2,1 in the patient (day 0) group, 0,49 ± 0,2 in the patient (day 7) group, and 11,0 ± 1,3 in the exitus group, with a statistically significant difference among the three groups (p<0,001). Additionally, the sensitivity of raftlin levels in predicting mortality was found to be %100, specificity %80, AUC 0,92 and the threshold value >475,61 ng/ml. In conclusion, evaluating our study suggests that raftlin levels can be used not only in diagnosing sepsis but also as a biomarker in predicting poor prognosis due to higher raftlin levels. While these findings are promising in suggesting that raftlin could be an ideal sepsis biomarker, more studies are needed in a larger population of neonates.