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ORIGINAL RESEARCH

The Role of Albumin in the Diagnosis of Neonatal Sepsis Over the Last 11 Years: A Retrospective Study

ORCID Icon, , , , , , , & show all
Pages 2855-2863 | Received 02 May 2023, Accepted 27 Jun 2023, Published online: 19 Jul 2023
 

Abstract

Background

There are many difficulties and uncertainties in the early diagnosis of neonatal sepsis. The aim of this study was to determine whether albumin (ALB) is useful for the early diagnosis of neonatal sepsis using ALB, C-reactive protein (CRP) and procalcitonin (PCT) together.

Methods

ALB, CRP, PCT and white blood cell (WBC) data from 732 patients with neonatal sepsis and 1317 neonatal infection patients hospitalized in Foshan Maternal and Child Health Hospital from 2011 to 2022 were collected. Receiver operating characteristic (ROC) and logistic regression analyses were performed to assess the diagnostic value of ALB, CRP, PCT and the WBC count for neonatal sepsis. The roles of ALB, CRP, PCT and the WBC count in the diagnosis of neonatal sepsis were analysed by using subject working characteristics (ROC) and areas under the curve (AUCs), and the variables were combined to determine which combination had the best diagnostic efficacy.

Results

In the sepsis group, the ALB, CRP, and PCT levels and the WBC count were significantly higher than those in the infection group (P<0.001). In all infants, the sensitivities and specificities of ALB, CRP, PCT, and WBC count were 0.411, 0.596, 0.483 and 0.411, respectively, and 0.833, 0.846, 0.901 and 0.796, respectively. With a sensitivity of 0.646, a specificity of 0.929, and an AUC of 0.834, the best combination was that of ALB, CRP, and PCT, which was better than that of CRP + PCT, CRP + ALB and PCT + ALB.

Conclusion

In neonatal sepsis, in the absence of blood culture results, the combination of ALB, CRP, and PCT is more reliable than CRP, PCT, or CRP+PCT alone. These results suggest that ALB is a useful inflammatory biomarker for the early diagnosis of neonatal sepsis, and can improve the diagnostic efficiency.

Data Sharing Statement

Upon reasonable request, the corresponding author can provide the datasets used and/or analysed during the current study.

Ethics Approval and Consent to Participate

The Affiliated Foshan Maternity & Child Healthcare Hospital’s Ethics Committee approved this study. The data collected for this study were retrospectively collected, and the datasets were completely anonymized before analysis. The Hospital’s Academic Board waived the need for consent.

Acknowledgments

We thank Da-zhi Fan for his many suggestions regarding this article.

Author Contributions

All authors made a significant contribution to the work reported, whether in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors declare that they have no competing interests in this work.

Additional information

Funding

This work was supported by the Foshan Self-funded Science and Technology Plan Project (No: 2220001004133).