Jornal de Hematologia e Doenças Tromboembólicas
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Hematologic Scoring System (HSS) As a Tool for Early Diagnosis of Neonatal Sepsis: A Systematic Review and Meta-Analysis

Fortunato N Grandeza III*, Hayzell Joy L Resurreccion

Objective: To evaluate the accuracy of the Hematologic Scoring System as a tool for the early diagnosis of neonatal sepsis

Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram was utilized for identification, screening and identification of eligible studies. Databases (PubMed, Herdin, Cochrane Library, Medline, Ovid, Google Scholar) were searched for relevant studies involving Hematologic Scoring System (HSS) by included studies were assessed for quality and risk of bias. Study design such as cross-sectional, randomized controlled trials, case controls that looked into neonates, term (>37weeks) or preterm (<37weeks), admitted in the Neonatal Intensive Care unit, with age from birth for up to 28 days of life, with clinical suspicion of neonatal sepsis were included.

Results: The Hematologic Scoring System (HSS) score of 3 and above as cut-off is accepted for initiation of treatment. The study showed a pooled diagnostic odds ratio of 34.55 (95% CI: 14.22-83.93). The pooled sensitivity is at 0.41 (0.38-0.44) at 95% CI and a specificity of 0.99 (0.98-1.00) at 95% CI. However, there is high statistical heterogeneity

Conclusion: This systematic review and meta-analysis analyzed fair to good quality evidences which revealed that the Hematologic Scoring System (HSS) is an accurate and a reliable screening tool for the diagnosis of Neonatal Sepsis. It is a quick and economical screening tool that is objective and thus increases the weight of a regular Complete Blood Count (CBC). Mostly, the source of studies that were used in this meta-analysis usually lacks specific information on the background of the neonates; prenatal and postnatal, the time when the extraction was done and other issues surrounding a sick neonate. A more rigorous and meticulous study design such as a randomized controlled trials made in our setting are needed to further determine its accuracy in diagnosing neonatal sepsis.