DIAGNOSTIC UTILITY OF RED CELL DISTRIBUTION WIDTH IN NEONATAL SEPSIS – AN OBSERVATIONAL STUDY

Abstract

Neonates with sepsis usually present with nonspecific symptoms making the diagnosis difficult. The gold standard for diagnosis of sepsis is blood culture but it’s positive only in 40% of the cases. The investigations complete blood count and C reactive protein are used for early diagnosis, but they are not as conclusive as blood culture. Red cell distribution width is defined as the variation in red blood cell volume. It is a measure of erythrocyte size. Recent studies show that RDW is raised significantly in sepsis.

Objective: To assess the diagnostic utility of red cell distribution width in neonates with sepsis. Methods: we conducted an observational, cross sectional, descriptive study over a period of 18 months. All neonates who underwent sepsis screen during the study period were included in this study. Results: The mean RDW in the no sepsis and probable sepsis and culture proven sepsis were 15.019% (14.78% - 15.25%), 15.87% (15.56% - 16.19%), and 16.30% (15.84% - 16.76%) respectively. The comparison of the mean values of RDW in three study groups was significant with a p-value < 0.001. No correlation was found between RDW and CRP (r= 0.128, p =0.085). For the RDW cutoff value of 14.95%, sensitivity was 88.6% and specificity was 54.8%. The positive predictive value of RDW in predicting neonatal sepsis was 66.9%, and the negative predictive value was 72.6%.