Clinical Value of C-Reactive Protein/Platelet Ratio in Neonatal Sepsis: A Cross-Sectional Study

Figures & data

Table 1 Basic Characteristics of Study Subjects

Variables	Infection (n = 449)	Sepsis (n = 599)	Sepsis
			Mild Sepsis (n = 256)	Severe Sepsis (n = 343)
Age (days)	7.0 (4.0, 12.0)	11.0 (6.0, 17.0)^a	11.0 (6.0, 18.0)^c	10.0 (6.0, 16.0)^d
Male, n (%)	262 (58.4%)	375 (62.6%)	165 (64.5%)	210 (61.2%)
Weight (kg)	3.3 ± 0.5	3.2 ± 0.6^a	3.3 ± 0.6	3.1 ± 0.7^bd
Temperature (°C)	37.0 ± 0.5	37.3 ± 0.8^a	37.4 ± 0.7^c	37.3 ± 0.8^d
Respiratory (rate/minute)	46.5 ± 7.6	49.7 ± 10.1^a	49.4 ± 9.6^c	50.0 ± 10.4^d
Heart rate (bpm)	142.7 ± 16.1	150.3 ± 18.0^a	149.6 ± 17.7^c	150.8 ± 18.3^d
SBP (mm Hg)	76.4 ± 7.1	76.3 ± 8.0	79.3 ± 5.6^c	74.1 ± 9.0^bd
DBP (mm Hg)	46.6 ± 7.3	46.2 ± 7.8	47.7 ± 7.6	45.0 ± 7.7^bd
Laboratory tests
PCT (ng/mL)	0.14 (0.09, 0.22)	0.28 (0.13, 1.23)^a	0.22 (0.11, 0.66)^c	0.36 (0.65, 1.88)^bd
CRP (mg/L)	0.7 (0.7, 0.7)	0.7 (0.7, 12.8)^a	0.7 (0.7, 8.1)^c	0.7 (0.7, 17.5)^bd
WBC (10^9 cells/L)	10.0 (8.1, 12.2)	10.0 (7.3, 13.9)	9.4 (7.4, 12.6)	10.7 (7.0, 15.8)^bd
Neutrophils (10^9 cells/L)	4.18 (3.13, 5.82)	4.89 (3.02, 8.33)^a	4.47 (3.01, 6.95)	5.52 (3.05, 9.37)^bd
PLT (10^9 cells/L)	293.0 (229.5, 365.0)	266.0 (170, 364.0)^a	297.0 (216.2, 368.7)	237.0 (121.0, 359.0)^bd
CPR (mg/10^6 cells)	2.49 (1.95, 3.56)	4.81 (2.28, 57.05)^c	3.10 (2.15, 26.06)^c	8.97 (2.63, 96.60) ^bd
AST (U/L)	37.5 (30.0, 49.9)	37.8 (27.9, 52.7)	36.2 (27.9, 47.9)	38.9 (27.8, 58.5)^b
ALT (U/L)	25.1 (20.0, 33.4)	28.6 (22.1, 37.9)^a	28.7 (22.7, 36.2)^c	28.5 (22.0, 39.6)^d
BUN (mM)	2.2 (1.4, 3.3)	3.0 (1.9, 4.2)^a	2.8 (1.8, 3.9)^c	3.2 (1.9, 4.7)^bd
CREA (μM)	50.0 (41.3, 57.6)	45.2 (35.9, 60.3)^a	43.3 (34.7, 53.2)^c	47.7 (37.2, 64.3)^b
UA (μM)	137.5 (103.0, 178.9)	143.0 (106.5, 195.6)^a	140.7 (106.7, 182.9)	143.8 (105.4, 207.0)^d

Notes: All values are presented as the mean ± SD or n (%) or as the median (interquartile range); ^aP < 0.05 for sepsis vs control; ^bP < 0.05 for severe sepsis vs mild sepsis; ^cP < 0.05 for mild sepsis vs control; ^dP < 0.05 for severe sepsis vs control.

Abbreviations: SBP, systolic blood pressure; DBP, diastolic blood pressure; PCT, procalcitonin; CRP, C-reactive protein; AST, aspartate aminotransferase; ALT, alanine aminotransferase; BUN, blood urea nitrogen; CREA, creatinine; UA, uric acid; CPR, C-reactive protein-to-platelet ratio.

Table 2 The Presence and Severity of Neonatal Sepsis Based on CPR Tertiles

Variables	Tertile 1 (< 2.33) (n = 350)	Tertile 2 (2.33–5.52) (n = 349)	Tertile 3 (> 5.52) (n = 349)
Age (days)	11.0 (7.0, 16.0)	6.0 (4.0, 13.0)^a	9.0 (5.0, 16.0)^bc
Male, n (%)	187 (53.4%)	226 (64.8%)^a	224 (64.2%)^b
PCT (ng/mL)	0.12 (0.09, 0.18)	0.17 (0.11, 0.35)^a	0.50 (0.19, 2.92)^bc
WBC (10^9 cells/L)	10.7 (8.9, 13.5)	8.9 (7.0, 11.6)^a	10.1 (6.8, 14.2)^bc
Neutrophils (10^9 cells/L)	4.3 (3.3, 6.3)	4.3 (2.8, 6.3)	5.0 (3.1, 9.1)^bc
Clinical data
Infection, n (%)	194 (55.4%)	191 (54,7%)	64 (18.3%)^bc
Overall sepsis, n (%)	156 (44.6%)	158 (45.3%)	285 (81.7%)^bc
Mild sepsis, n (%)	81 (23.1%)	79 (22.6%)	96 (27.5%)
Severe sepsis, n (%)	75 (21.4%)	79 (22.6%)	189 (54.2%)^bc

Notes: ^aP < 0.05 for Tertile 2 vs Tertile 1; ^bP < 0.05 for Tertile 3 vs Tertile 1; ^cP < 0.05 for Tertile 3 vs Tertile 2.

Abbreviations: abbreviations as in Table 1.

Table 3 Regression Analysis to Assess the Presence of Neonatal Sepsis and Severe Sepsis Based on CPR Tertiles

Variables	Univariate		Multivariate*
	OR (95% CI)	P	OR (95% CI)	P
Presence of sepsis
CPR	1.024 (1.017–1.032)	< 0.001	1.015 (1.008–1.022)	< 0.001
CPR tertiles
Tertile 1	1		1
Tertile 2	1.029 (0.764–1.386)	0.852	0.908 (0.628–1.313)	0.628
Tertile 3	5.538 (3.928–7.807)	< 0.001	2.331 (1.527–3.559)	< 0.001
Presence of severe sepsis
CPR	1.004 (1.003–1.006)	< 0.001	1.002 (1.000–1.003)	0.007
CPR tertiles
Tertile 1	1		1
Tertile 2	1.073 (0.750–1.534)	0.700	0.929 (0.623–1.385)	0.717
Tertile 3	4.331 (3.111–6.030)	< 0.001	1.918 (1.291–2.850)	0.001

Notes: *Adjusted for age, temperature, heart rate, respiratory rate, weight, PCT, Neutrophil, ALB, ALP, AST, ALT, UREA and UA.

Abbreviations: abbreviations as in Table 1.

Figure 1 ROC curve of CPR in predicting sepsis and severe sepsis in neonates. (A) The ROC curve for CPR in predicting sepsis. (B) The ROC curve for CPR in predicting severe sepsis.