Evaluation of haematological scoring system as a screening tool for early detection of neonatal sepsis


  • Akshay Radhakrishnan Department of Paediatrics, Govt. T. D. Medical College, Alappuzha, Kerala, India
  • Jayaram Sankar K. R. Department of Paediatrics, Govt. T. D. Medical College, Alappuzha, Kerala, India




HSS, Neonatal sepsis, NPV


Background: Early diagnosis of neonatal septicemia is a vexing problem because of its nonspecific clinical picture. Hence the timely diagnosis of sepsis in neonates is critical as the illness can be rapidly progressive and, in some instances, fatal. The current study was undertaken to assess the significance of the hematological scoring system (HSS) for early detection of neonatal sepsis. Objectives were to assess the effectiveness of HSS in early detection of neonatal sepsis by comparing it with blood culture result, in neonates who were clinically suspected to have bacterial infection

Methods: This is a descriptive study done in TDMCH, Vandanam for a period of 1 year. All babies who were at risk of developing sepsis were studied after applying inclusion and exclusion criteria. Blood samples were collected and subjected to sepsis work up. HSS scoring was done. Sensitivity, specificity, positive predictive value (PPV), Negative predictive value (NPV) of HSS and each of its components were calculated.

Results: Among the 85 neonates studied, 39 (45.9%) were blood culture positive, 42 (49.4%) had HSS score of 5 or more. HSS score had sensitivity of 92.31%, specificity of 86.96%, PPV of 85.71% and NPV of 93.02%.

Conclusions: HSS score of ≥5 had high NPV and would play a major role in ruling out neonatal sepsis.


Mohammad S, Aletayeb MH, Khosravi AD, Dehdashtian M, Kompani F, Mortazavi M et al. Identification of bacterial agents and antimicrobial susceptibility of neonatal sepsis: A 54-month study in a tertiary hospital. Afr J Microbiol Res. 2011;5(5):528-31.

Ognean ML, Boicean A, Șular FL, Cucerea M. Complete blood count and differential in diagnosis of early onset neonatal sepsis. Rev Romana Med Lab. 2017;25(1):101-8.

Guerti K, Devos H, Ieven M, Mahieu L. Time to positivity of neonatal blood cultures: Fast and furious? J Med Microbiol. 2010;60(4):446-53.

Wynn JL. Defining neonatal sepsis. Curr Opin Pediatr. 2016;28(2):135-40.

Rodwell RL, Leslie AL, Tudehope DI. Early diagnosis of neonatal sepsis using a hematologic scoring system. J Pediatr. 1988;112(5):761-7.

Rodwell RL, Taylor KM, Tudehope DI, Gray PH. Hematologic scoring system in early diagnosis of sepsis in neutropenic newborns. Pediatr Infect Dis J. 1993;12(5):372-6.

NA. Neonatal bacteraemia: diagnosis and management. Br Med J. 1979;2(6202):1385-6.

Derbala SG, Handoka NM, Hasan BBE, El-Sayed HF. Performance of the Hematological Scoring System for Early Diagnosis of Neonatal Sepsis. Infect Dis Trop Med. 2017;3(4):e429.

Mary BV. Evaluation of Haematological Scoring System in Early Diagnosis of Neonatal Sepsis. 2019. Available at: http://repository-tnmgrmu.ac.in/11158/. Accessed on 2 January, 2023.

Narasimha A, Harendra Kumar ML. Significance of Hematological Scoring System (HSS) in Early Diagnosis of Neonatal Sepsis. Indian J Hematol Blood Transfus Off J Indian Soc Hematol Blood Transfus. 2011;27(1):14-7.

Bhalodia MJ, Hippargi SB, Patil MM. Role of hematological scoring system in diagnosis of neonatal sepsis. J Clin Neonatol. 2017;6(3):144.






Original Research Articles