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Subject Area

Clinical Pathology

Article Type

Original Study

Abstract

Objective The aim was to assess the potential role of serum thrombomodulin level as a biochemical diagnostic marker in neonates with septic shock. Background Neonatal septic shock is a significant cause of morbidity and mortality. Thrombomodulin is expressed on vascular endothelial cells and is found in the body in a bound form and a soluble form. Patients and methods This prospective cohort study was done on 120 neonates who were divided into two groups: patients' group included 80 neonates with septic shock, and control group included 40 healthy neonates. Detailed history, thorough clinical examination, and laboratory investigations including level of serum soluble thrombomodulin were done. Results Neonates with septic shock had statistically significant higher level of serum soluble thrombomodulin than controls. Serum soluble thrombomodulin levels were significantly higher in patients with gram-positive bacteria in comparison with gram-negative ones. Nonsurviving septic neonates had statistically significant increase in serum soluble thrombomodulin levels than survived septic neonates. There was a statistically significant positive correlation between serum soluble thrombomodulin levels and quantitative C-reactive protein (CRP) values. The cutoff value of 20 of serum soluble thrombomodulin levels had a sensitivity of 91.5%, a specificity of 84.7%, positive predicted value of 91.9%, negative predicted value of 88.3% with accuracy 92.94% in the diagnosis of septic shock. Serum soluble thrombomodulin showed a higher accuracy in the diagnosis of septic shock than quantitative CRP values. Conclusion Serum soluble thrombomodulin level has a more sensitivity diagnostic role in septic shock than quantitative CRP value. Higher serum soluble thrombomodulin levels predict the prognosis of septic shock.

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