Can Systemic Immune Inflammatory Index Predict Nosocomial Infection in Term Newborns who Underwent Congenital Cardiac Surgery?

Abstract Background: In this study, the aim was to investigate the contribution of early-stage systemic immune inflammatory index(SII) and acute phase reactants to predict nosocomial infections in term newborns who underwent congenital heart surgery. Methods: This study was carried out retrospectively in newborns who were followed up in the pediatric cardiac intensive care unit between November 1, 2021 and December 1, 2022 and had had cardiac surgery. Demographic and clinical features, changes in systemic inflammatory index (platelet count x neutrophil count/lymphocyte count) and acute phase reactants in the preoperative and postoperative first 72 hours were evaluated in patients with or without nosocomial infection.The results were analyzed statistically. Results: During the study period, cardiac surgery was performed in 160 neonates. Median age was 10 days(IQR 6 days -15 days) and median weight was 3 kg(IQR 2.8 kg -3.2 kg).Eighty of the patients were male(50%).55 different nosocomial infections were detected in 44 patients(27.5%). Bloodstream infections were the most common with 62%, followed by lower respiratory tract infections in 23% and wound infections in 15%.Mortality due to nosocomial infection was determined as 34%.SII and NLR values measured on the 2nd and 3rd postoperative days were significantly higher in patients with nosocomial infection (p510((72% specificity 85% sensitivity) on postoperative 2nd day and SII >730(72% specificity 80% sensitivity) on postoperative 3rd day were predicting nosocomial infection strongly. Conclusion: Nosocomial infections are an important cause of mortality and morbidity in newborns with congenital heart surgery. Easy-to-use systemic inflammatory index measurement can help to predict nosocomial infections.