The diagnostic value of cerebrospinal fluid protein in the assessment of neurological outcome in preterm infants with sepsis

Objective To investigate the diagnostic value of cerebrospinal fluid protein in the assessment of neurological outcome in preterm infants with sepsis. Methods A total of 80 preterm infants with sepsis were enrolled in the department of neonatology of Shanghai Children′s Hospital from June 2014 to June 2016.The lumbar puncture was completed within 24 hours after diagnosis of sepsis, and the results of cerebrospinal fluid protein were obtained.The prognosis of neurological development was assessed according to Gesell Developmental Quotient (DQ) at 6 months of adjusted gestational age.DQ> 85 was used as an indicator of good prognosis group.DQ≤85 was assigned to the poor prognosis group.The differences in protein content of cerebrospinal fluid between these two groups were retrospectively analyzed.The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of cerebrospinal fluid in evaluating the prognosis of preterm infants with sepsis. Results Cerebrospinal fluid protein content of poor prognosis group was higher than those in good prognosis group[(2 005.56±582.85)mg/L vs.(1 367.92±362.29)mg/L, t=-6.019, P<0.01]. The area under the ROC curve was 0.819(95%CI 0.711-0.927, P<0.05). The optimal threshold of cerebrospinal fluid protein was 1 560 mg/L with specificity of 75.5% and sensitivity of 81.5%. Conclusion Cerebrospinal fluid protein content has certain diagnostic value on the assessment of sepsis premature neurological prognosis. Key words: Sepsis; Preterm infants; Cerebrospinal fluid protein; Gesell Developmental Schedules; Neurodevelopment outcome