Page 85 - Abstract Book KONIKA 18

Neonatology

O-NEO-009
Neutrophil-lymphocyte Ratio and Platelets-lymphocyte Ratio
as Predictor of In-hospital Mortality among NICU Newborns:
Cheap Test to Screen High Risk Patients

1
Riyanti Teresa Arifin , Tietha Kerihi , Freddy Norman Hanas , Tjahyo Suryanto ,
2
1
2
Regina Maya Manubulu , Woro Indri Padmosiwi 1
1
Department of Child Health and Emergency Department , Prof. W.Z. Johannes Hospital, Kupang,
2
1
East Nusa Tenggara, Indonesia
Abstract
Background Systemic inflammation is associated with most critical illness. Common inflammation
biomarkers need additional tests and cost. Neutrophil lymphocyte ratio (NLR) and Platelets lymphocyte
ratio (PLR) were highlighted recently to predict poor outcome in critical adults and children. Absolute
lymphocyte and neutrophil count (ALC and ANC) were also thought could be useful parameters. Objective
To explore role of NLR, PLR, ALC and ANC as mortality predictor among NICU patients. Methods A
retrospective cohort study collected first 24 hours complete blood count (CBC) data of randomized newborns
who admitted to NICU of Prof. WZ Johannes Regional Hospital. Independent t-test, Mann-Whitney test
and Receiver Operating Characteristic (ROC) curves were analyzed and constructed. P value <0.05 was
considered as significant. Results Of 69 newborns data, 28 (40.6%) of them died during admission. 52.2%
of them were born with low birth weight and 65.2% were preterm. The NLR >1.69 had sensitivity 67.9%
and specificity 92.7% (AUC 0.841, P=0.000). PLR > 28.2 had sensitivity 71.4% and specificity 70.7%
(AUC 0.76, P=0.004). ANC >7.52 had sensitivity 64.3% and specificity 80.5% (AUC 0.781, P=0.000).
ALC < 3.56 had sensitivity 63% and specificity 85.4% (AUC 0.764, P=0.000) for predicting in-hospital
mortality. Conclusion NLR, PLR, ANC and ALC are the novel inflammation biomarkers which could be
used to predict poor prognosis of NICU babies. These parameters are cheap, easy and reachable tests for
any rural and primary health center. Attaching these parameters in CBC results could be considered to warn
healthcare workers which baby needs to be referred or highly observed.
Keywords: neonatal mortality; hematological test; newborn screening; nicu

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