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All Journal Nexus Kedokteran Klinik Sari Pediatri Paediatrica Indonesiana Indonesian Journal of Medicine Journal of Maternal and Child Health Jurnal Kesehatan Karya Husada Jurnal Keperawatan dan Kesehatan Plexus Medical Journal
Dwi Hidayah
Faculty of Medicine, Sebelas Maret University
Dentistry Health Professions Medicine & Pharmacology Nursing Public Health

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Journal : Paediatrica Indonesiana

 1 
Platelet lymphocyte ratio (PLR), neutrophil lymphocyte ratio (NLR), and diastolic dysfunction as neonatal sepsis mortality predictors in preterm neonates Tampy, Safitri Tia; Hidayah, Dwi; Lilijanti, Sri
Paediatrica Indonesiana Vol. 65 No. 3 (2025): May 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.3.2025.216-23

Abstract

Background Neonatal sepsis is a significant challenge in neonatal care, particularly among preterm neonates who are highly vulnerable due to their underdeveloped immune systems. Traditional markers for predicting the outcomes of neonatal sepsis, such as procalcitonin and C-reactive protein, are not always available all across places. Objective To evaluate the predictive value of platelet lymphocyte ratio (PLR), neutrophil lymphocyte ratio (NLR), and diastolic dysfunction for neonatal sepsis mortality in preterm neonates. Methods A prospective cohort study was conducted in 42 preterm neonates with neonatal sepsis admitted to Dr. Moewardi Hospital. The PLR and NLR were collected at two time points: the first blood specimen was drawn within the first 24 hours of life and the second was collected 72 hours later. Diastolic function was assessed by echocardiography performed within 48–72 hours after the diagnosis of sepsis. Mortality during treatment was recorded as the dependent variable. The relationships among these variables were analyzed with bivariate and multivariate analyses, and the significance level was set at P<0.05. Results Of 42 subjects, 57.1% died. Increased NLR and diastolic dysfunction were significantly associated with an increased risk of mortality (OR=3.64; P=0.049 and OR=25.0; P<0.001, respectively), while PLR was not. Multivariate analysis revealed that diastolic dysfunction  remain a significant independent predictor of mortality (adjusted OR=28.9;P=0.001), whereas NLR did not maintain statistical significance (P=0.093). Conclusion Diastolic dysfunction was an independent predictor of mortality in preterm neonatal sepsis. The NLR and PLR did not associate with mortality in preterm neonatal sepsis. Rigorous monitoring of cardiovascular function is crucial in the management of neonatal sepsis.
Red-cell distribution width and immature to total ratio as predictors of sepsis mortality in preterm neonates Aziz, Abdul; Hidayah, Dwi; Widiretnani,  Septin
Paediatrica Indonesiana Vol. 65 No. 6 (2025): November 2025
Publisher : Indonesian Pediatric Society

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Abstract

Background Preterm neonates are susceptible to various complications and may require invasive procedures that increase the risk of sepsis, which is the third leading cause of mortality in children. Routine laboratory results, such as red-cell distribution width (RDW) and immature to total neutrophil (I/T) ratio, may be useful as predictors of mortality in neonatal sepsis patients. These laboratory markers have undergone limited testing as mortality predictors in preterm neonates with sepsis. Objective To analyze the predictive ability of RDW and I/T ratio on sepsis mortality in preterm neonates. Methods This prospective cohort study included 42 preterm neonates (gestational age 28-36 weeks + 6 days), with birth weight appropriate to gestational age. The diagnosis of sepsis was established based on the high probable sepsis (HPS) and probable sepsis (PRS) criteria scores. RDW and I/T ratio values were obtained at the time of the sepsis diagnosis. Neonatal mortality was defined as death occurring within the first 28 days of life. Receiver operating characteristic (ROC) curve was used to analyze for associations between mortality and the laboratory markers. Results The median RDW in preterm neonates who died was 16.5% (range 14.0-32.7%). This was relatively similar to the median RDW value in preterm neonates who lived (16.25%; range 14.6-34.3%). ROC curve analysis revealed an area under curve (AUC) of 0.541 (95%CI 0.359 to-0.722; P=0.656). The median I/T ratio in preterm neonates who died was 0.13 (range 0.03-0.22), which was similar to the median I/T ratio in preterm neonates who lived (0.15; range 0.11-8.20). The AUC value was 0.387 (95%CI 0.214 to -0.559; P=0.213). Conclusion The RDW and I/T ratio values cannot be used as predictors of sepsis mortality in preterm neonates.
Co-Authors . Ardiningsih Abdul Aziz Al Khusna, Nandia Permata Rahma Annang Giri Moelyo Artiko, Bagus Candrarukmi, Dewinda Dio Dara Virgiansari Djaswadi Dasuki Endang Sutisna Sulaeman Harsono Salimo Leli Saptawati Lilijanti, Sri Miftachuljannah, Regita Ayu Nabiilah, Khusniyatin Dwi Nugraha, Sandi Nugroho, Irfan Dzakir Nuniek Setyo Wardani Nur Irfani Agita Pratomo, Satrio Rachma, Ulfa Puspita Rinawati Rohsiswatmo Suryani, Fitri Ika Tampy, Safitri Tia Widiretnani,  Septin Yulidar Hafidh