Peer Review Report For: Accuracy of Systemic Inflammatory Indices in identifying Neonatal Sepsis in preterms in a tertiary care hospital in Mangalore [version 1; peer review: 2 approved with reservations, 1 not approved]

Background Both term and preterm neonates can develop sepsis, a potentially lethal and life-threatening condition, during the first 28 days of life. Neonatal sepsis accounts for 8% of all neonatal fatalities. This study aimed to evaluate the predictive power of lab-based diagnostic indices for neonatal sepsis in preterm infants. Methods The Systemic Inflammatory Indices of the two groups of preterms – one control group without sepsis and one case group with sepsis–were compared to assess their value in predicting Neonatal Sepsis. Data from 138 preterm neonates were used in the present study. Systemic Inflammatory Indices were calculated and compared from the collected data in both the case and control groups. Results Platelet count, Pan Immune Inflammation Value (PIV), Platelet to Lymphocyte Ratio (PLR) and Systemic Immune Inflammatory Index (SII) were found to be significant predictors of neonatal sepsis. Platelet count had the highest predictive value, with an AUC value of 0.715 and optimal cut-off value of 219500. It had a sensitivity of 75.4 and specificity of 65.2. Conclusion According to this study, sepsis in preterm infants can be predicted by using systemic inflammatory indices. This will aid in early sepsis diagnosis and management and, in turn, reduce neonatal morbidity and mortality associated with sepsis.