New Diagnostic Parameter for Neonatal Sepsis: Red Cell Distribution Width Fluctuations

Abstract Background: To evaluate the role of red cell distribution width (RDW) fluctuations in the diagnosis of neonatal sepsis. Methods: In this retrospective cohort study of the Medical Information Mart for Intensive Care III database (version 1.4), newborns with sepsis were matched with patients without sepsis to analyze RDW as a diagnostic marker. Those newborns were analyzed based on gestational age, sex, and ethnicity. Receiver operating characteristic (ROC) analysis and multiple logistic regression were used to evaluate RDW fluctuation for sepsis diagnosis. Results: A total of 2456 neonates were included. RDW fluctuations showed better accuracy than the maximum RDW did (area under the curve (AUC): 0.88 vs. 0.81, sensitivity 92.10% vs. 78.70%; specificity 71.70% vs. 69.30%, respectively). Furthermore, logistic regression analysis showed a positive association between RDW fluctuation and the diagnosis of sepsis (odds ratio 1.13; 95% confidence interval, 1.08–1.18) after adjusting for gestational age, hemoglobin, and white blood cell count. Conclusion: RDW fluctuations might be a potential diagnostic marker for NICU patients with sepsis.