Page 62 - Abstract Book KONIKA 18

Emergency & Pediatric Intensive Care

O-EPIC-003
Diagnostic Value of Neutrophil-Lymphocyte Ratio
in Diagnosing Bacteremia in Sepsis Children

Eva, Aizah Lawang, Idham Jaya Ganda
Department of Child Health, Faculty of Medicine, Universitas Hasanuddin, Dr. Wahidin Sudirohusodo General
Hospital, Makassar, South Sulawesi, Indonesia

Abstract
Background Bacteremia is the presence of bacteria in the blood based on a positive blood culture. Bacteremia
is one of the leading causes of morbidity and mortality worldwide, where late diagnosis increases mortality.
Changes in the dynamics and regulation of apoptosis in systemic inflammatory conditions result in an
increase in the number of neutrophils and a decrease in the number of lymphocytes. This immune response
can predict the extent to which the neutrophil-lymphocyte ratio detects bacteremia. Objective To determine
the neutrophil-lymphocyte ratio as a marker of bacteremia in children compared with culture as the gold
standard examination. Methods A cross sectional study in the Child Care Room and the Pediatric Intensive
Care Unit at RSUP. Dr. Wahidin Sudirohusodo Makassar from May to July 2021. It consisted of 84 children
with clinical bacteremia. Results The value of RNL (Neutrophil Lymphocyte Ratio) increased significantly
in the positive culture group. The cut-off point 3.195 for patients with positive culture results obtained
through ROC, with a sensitivity of 62.22%, specificity 64.1%, positive predictive value 66.67%, negative
predictive value 59.52%, the likelihood ratio is 0.015 and the odds ratio (OR) is 2.941 with 95%CI 1.208
to 7.159). Conclusion The neutrophil lymphocyte ratio can be used as a diagnostic value for patients with
clinical bacteremia with a P value = 0.029.
Keywords: neutrophil lymphocyte ratio; bacteremia; sepsis

O-EPIC-004
Correlation between Free Triiodothyronine with PELOD-2 score
and Outcomes in Critically Ill Pediatric Patient at Dr. M. Djamil Hospital Padang

Mohd Luthfi B., Mayetti Akmal, Indra Ihsan, Eka Agustia Rini
Department of Child Health, Faculty of Medicine Universitas Andalas/Dr. M. Djamil Hospital,
Padang, West Sumatera, Indonesia
Abstract
Background In critically ill pediatric patients, an increase of TNF-alpha, Interleukin-6, reactive oxygen
species, and decrease of leptin, selenium, the affinity of thyroid-binding globulin was found, which can cause
thyroid function abnormalities, known as Non-Thyroidal Illness (NTI). This is related to the severity of the
disease, which can be measured with a PELOD-2 score. Objective This study aims to describe the correlation
between free triiodothyronine (FT3) with PELOD-2 score and outcome in critically ill pediatric patients
at Dr. M. Djamil Hospital. Methods A cross-sectional study was prospectively conducted from May until
July 2021 at Pediatric Intensive Care Unit Dr. M. Djamil Hospital. Results A total of 23 samples enrolled in
this study, predominantly was male gender (60.9%) and 1-5 years. Mortality rate was 52% and mean length
of stay in PICU was 26 ± 9 days. FT3 was found low in all samples. FT3 was lower in PELOD-2 score ≥7
group than <7 group (1.13 ± 0.53 vs 1.56 ± 0.99 pg/ml, P=0.107) and in non-survival group compared to
survival group (1.11 ± 0.68 vs 1.62 ± 0.9 pg/ml, P=0.483). There was an inverse correlation between FT3
and PELOD-2 scores (r= -0.283, P=0.191) and length of stay in PICU (r= -0.621, P=0.041). Conclusion FT3
level has weak inverse correlation with PELOD-2 score which is not statically significant and has strong
inverse correlation with length of stay in PICU which is statically significant.

Keywords: critically ill; free triiodothyronine (FT3); PELOD-2 score; outcome

16 KONIKA XVIII Abstract Book