Application Of Improved Sequential Method In Febrile Neonates

Objective:An improved sequential method based on clinical and laboratory indexes was established to evaluate febrile neonates,and the value of improved sequential method in febrile neonates was evaluated by comparing it with the Lab-score.Methods : A retrospective study of 230 febrile neonates in our neonatal wards from October 2015 to October 2017.The accuracy of the study samples was analyzed by improved sequential method,and compared the accuracy between improved sequential method and laboratory score in the evaluation of the condition of febrile neonates.Results:Of the 230 cases of febrile neonates with full term without a history of disease,112(48.7%)were diagnosed with septicemia,according to the improved sequential method,the general conditions,age,urine routine,procalcitonin,C-reactive protein and neutrophils of neonates were evaluated and classified,and the prevalence rate of high-risk neonates classified by improved sequential method was significantly higher than low-risk neonates,the sensitivity,negative predictive value and negative likelihood ratio for ruling out an severe bacterial infection were 98.2%,94.8% and 0.02 respectively,and the lab-score were 66.1%,72.9% and 0.40.By the improved sequential method,two neonates with septicemia were mistakenly divided into low-risk neonates,and 38 neonates with sepsis were mistakenly into low-risk neonates by the Lab-score.Conclusions:The improved sequential method can identify high risk and low risk neonates,the improved sequential method is highly sensitive for infected neonates,compared to laboratory scores have higher application value.