Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Pediatrics

Introduction: Globally, sepsis is still one of the major causes of morbidity and mortality in neonates and its diagnosis is one of the most challenging aspects. Objectives: The aim of this study was to detect the potential role of serum level of adjusted ischemia modified albumin (IMA) in diagnosis of late onset neonatal sepsis and comparing it to other markers of sepsis such as CRP, hematological score and blood culture. Furthermore, as secondary outcomes, we focused on estimating the risk of higher levels of IMA for complications: Such as prolongation of hospital stay and neonatal mortality. Methods: This case control analytical study was carried out at NICU of Kasr Al-Ainy Hospital, Cairo University, Egypt, over a period from February to May 2018. It included 87 preterm neonates, 37 cases and 50 controls. We studied the potential role of serum level of adjusted ischemia modified albumin (IMA) in diagnosis of late onset neonatal sepsis and its sensitivity, specificity was compared to other markers of sepsis such as CRP, hematological score and blood culture. Also, we estimated the correlation and regression between the marker and duration of hospital stay and neonatal mortality. Results: Adjusted IMA in our study shows the following sensitivity, specificity, negative predictive value and positive predictive 86%, 94%, 91% and 90% respectively with an overall correct classification of 290.80%3. As for the cut-off, our marker showed a cut-off value of 80 ng/dl. While adding CRP to the model had negative effect, combining adjusted IMA and hematological score had the highest overall corrected value of 298%3 which is the highest among other markers. As for prognosis, our results show that there is a significant positive correlation between adjusted IMA and duration of hospital stay and that a higher cut off value for adjusted IMA (above 130 ng/dl) had direct effect on mortality with p-value of 0.0332

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