Prognostic significance of blood clotting indicators for determination of the probability of developing the hemorrhagic syndrome in premature newborns with congenital pneumonia

Abstract

One of the main complications of congenital pneumonia in premature newborns, leading to high mortality, is the development of hemorrhagic syndrome. Objective - to determine the prognostic significance of blood clotting indicators and the probability of developing hemorrhagic syndrome in premature newborns with congenital pneumonia.The assessment of hemostasis indicators in 221 premature newborns who were treated and cared for in the State Institution RSPC “Mother and Child” in the period from 2017 to 2019 was carried out. A comparative analysis of the parameters of the coagulogram of the first day of life was performed with the allocation of the percentile range and the translation of absolute values into binary variables is made. Based on the results of the ROC analysis, a mathematical model was developed with a universal coefficient equal to χ2 = 24.19, p = 0.004, with a sensitivity of 92.9 % and an area under the ROC-curve AUC = 0.69 ± 0.039 (0.62-0.76), p < 0.001, and a computer support program for doctors. The prognostic significance of blood clotting parameters was calculated: activated partial thromboplastin time - 0.366, coefficient R - 0.208, prothrombin time - 0.321, prothrombin index according to Quick - 0.330, international normalized ratio - 0.242, thrombin time - 0.319, fibrinogen -0.295, D-dimer - 0.448, platelets - 0.478, which makes it possible to allocate premature newborns with congenital pneumonia with a threshold value of ≥0.293 to the risk group for the development of hemorrhagic syndrome.