The Department of Pediatrics, The Fourth Hospital of Hebei Medical University, Shijiazhuang, PR China.
Medicine (Baltimore). 2022 Sep 9;101(36):e30526. doi: 10.1097/MD.0000000000030526.
To assess the early predictive value of maternal parameters for early-onset sepsis (EOS) in preterm infants, especially including the maternal neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and mean platelet volume (MPV). The retrospective cohort study examined a total of 231 preterm infants (69 with EOS) from May 2017 to October 2021 of the Fourth Hospital of Hebei Medical University, randomly divided (7:3) into the training set group (n = 162) and validation set group (n = 69). Thirteen clinical variables (including MPV, NLR, and PLR) were included as the research objects. By logistic regression, the factors significantly associated with EOS were distinguished. Additionally, a nomogram was constructed based on the independent risk factors, the validation of which relied on the concordance index, calibration curves, receiver operating characteristic curves, and decision curve analyses. Multivariate logistic regression proved that NLR (OR = 1.67, 95% CI = 1.18-2.36, P = .004), PLR (OR = 1.03, 95% CI = 1.01-1.04, P = .001), and MPV (OR = 1.75, 95% CI = 1.15-2.66, P = .009) were independent risk factors for EOS. The AUC of the nomogram for the training set group was 0.872 (0.814, 0.931) and 0.889 (0.843, 0.935) in the validation set group. The P values of Hosmer-Lemeshow test for the training set and validation set groups were .903 and .752, respectively. The decision curve analyses outcome indicated good clinical practicability. The C-index for the training set and validation set groups were 0.872 and 0.889, respectively. The maternal NLR, PLR, and MPV levels had good predictive value for EOS in premature infants. The nomogram in our study could help clinicians predict the occurrence of EOS.
为了评估母体参数对早产儿早发型败血症 (EOS) 的早期预测价值，特别是包括母体中性粒细胞与淋巴细胞比值 (NLR)、血小板与淋巴细胞比值 (PLR) 和平均血小板体积 (MPV)。这项回顾性队列研究共纳入了 2017 年 5 月至 2021 年 10 月河北医科大学第四医院的 231 例早产儿（69 例 EOS），随机分为（7：3）训练集组（n = 162）和验证集组（n = 69）。纳入了 13 个临床变量（包括 MPV、NLR 和 PLR）作为研究对象。通过逻辑回归，区分了与 EOS 显著相关的因素。此外，还基于独立风险因素构建了一个列线图，通过一致性指数、校准曲线、接受者操作特征曲线和决策曲线分析来验证。多变量逻辑回归证明，NLR（OR=1.67，95%CI=1.18-2.36，P=0.004）、PLR（OR=1.03，95%CI=1.01-1.04，P=0.001）和 MPV（OR=1.75，95%CI=1.15-2.66，P=0.009）是 EOS 的独立危险因素。训练集组的列线图 AUC 为 0.872（0.814，0.931），验证集组为 0.889（0.843，0.935）。训练集和验证集组的 Hosmer-Lemeshow 检验 P 值分别为.903 和.752。决策曲线分析结果表明具有良好的临床实用性。训练集和验证集组的 C 指数分别为 0.872 和 0.889。母体 NLR、PLR 和 MPV 水平对早产儿 EOS 具有良好的预测价值。本研究中的列线图可以帮助临床医生预测 EOS 的发生。
