The Diagnostic Predictive Value of Aspartate Aminotransferase/Platelet Ratio Index (APRI) in Assessing the Disease Severity of Filipino Dengue Patients in Pampanga, Philippines: A Multicenter Study

Abstract Introduction/Objective Lack of good predictive biomarkers tied with its widely varying clinical manifestation make DENV infection a major public health concern especially in developing countries like the Philippines. Liver involvement is found to be a common manifestation among severe dengue patients hence enzymes such as aspartate aminotransferase (AST) is used in determining dengue severity. This study aims to evaluate the predictive value of AST/platelet ratio index (APRI) in assessing disease severity among Filipino dengue patients upon admission. Methods/Case Report Clinical data of 16 dengue patients from two hospitals in Pampanga were analyzed retrospectively. Results for NS1 antigen test, CBC, and AST along with signs and symptoms of patients upon admission were reviewed. ANCOVA was used to compare AST and APRI between the groups while ROC regression and Youden’s index were utilized in identifying severe dengue using AST and APRI. Results (if a Case Study enter NA) Among the 16 patients, 10 were male and 6 were females with a mean age of 17.9 years (range, 6 to 34). There was no evidence that AST (p=0.223) significantly differed between severe and non- severe dengue, with a mean of 131.0±24.5 and 78.5±24.5, respectively. Calculated APRI scores (p=0.604) did not show significant difference between SD and NSD, with a mean of 3.8± 4.1 and 3.7±4.1, respectively. The obtained AST cutoff for SD was 119 U/L; while the APRI cutoff for SD is 4.03. However, considering the age of patients as covariate, both AST [AUC = 0.55 (95% CI: 0.15 to 0.86)] and APRI [AUC = 0.69 (95% CI: 0.27 to 1.00)] was not able to differentiate patients with SD and NSD. Conclusion The parameters AST and APRI were not able to differentiate and predict severity between SD and NSD. A larger cohort with a more specific age group, and collection of samples throughout the course of illness are needed to further substantiate the results.

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Seroprevalence of Cysticercosis in Children and Young Adults Living in a Helminth Endemic Community in Leyte, the Philippines

Journal of Tropical Medicine ◽

10.1155/2010/603174 ◽

2010 ◽

Vol 2010 ◽

pp. 1-6 ◽

Cited By ~ 7

Author(s):

Jin-Mei Xu ◽

Luz P. Acosta ◽

Min Hou ◽

Daria L. Manalo ◽

Mario Jiz ◽

...

Keyword(s):

Public Health ◽

Taenia Solium ◽

Public Health Problem ◽

The Philippines ◽

Health Concern ◽

Public Health Concern ◽

Significant Difference ◽

Significant Public Health Problem ◽

Significant Public Health ◽

Children And Young Adults

Cysticercosis is a significant public health problem in countries where pigs are raised for consumption and remains an important cause of neurological disease worldwide. The Philippines is considered an endemic area for cysticercosis because cases in both humans and pigs have been reported; however, epidemiologic information stays limited. We conducted a pilot survey of the seroprevalence of human cysticercosis in a village in Leyte, the Philippines, by measuring antibody specific forTaenia soliumcyst-fluid antigen. There were 497 subjects aged 7–30 years in our study and most subjects were infected with one or more helminths. The overall cysticercosis seroprevalence in this population was 24.6% (95% CI: 20.82% ~ 28.58%) with no significant difference based on age, sex, or other helminth coinfection status. Although the sample may not be representative of the whole community, the findings suggest that cysticercosis is a significant, but underrecognized public health concern in the Philippines.

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C-Reactive Protein-to-Albumin Ratio as a Prognostic Inflammatory Marker in COVID-19

Journal of Laboratory Physicians ◽

10.1055/s-0041-1741439 ◽

2022 ◽

Author(s):

Aliye Çelikkol ◽

Eda Çelik Güzel ◽

Mustafa Doğan ◽

Berna Erdal ◽

Ahsen Yilmaz

Keyword(s):

Disease Severity ◽

Predictive Value ◽

Rt Pcr ◽

C Reactive Protein ◽

Albumin Ratio ◽

Lymphocyte Ratio ◽

Reactive Protein ◽

Cell Counts ◽

Nonparametric Distribution ◽

Significant Difference

Abstract Objectives As a result of developed generalized inflammation, the main prognostic factor determining morbidity and mortality in coronavirus disease 2019 (COVID-19) patients is acute respiratory distress syndrome. The purpose of our study was to define (1) the laboratory tests that will contribute to the diagnosis and follow-up of COVID-19 patients, (2) the differences between the laboratory-confirmed (LC), unconfirmed (LUC), and control (C) groups, and (3) the variation between groups of acute-phase reactants and biomarkers that can be used as an indicator of disease severity and inflammation. Materials and Methods A total of 102 patients undergoing treatment with COVID-19 interim guidelines were evaluated. Reverse transcriptase-polymerase chain reaction (RT-PCR) test was positive in 56 (LC), classified as mild or severe, and negative in 46 (LUC) patients. In addition, 30 healthy subjects (C) with negative RT-PCR tests were also evaluated.All statistical analyses were performed with the SPSS 22.0 program and the p-values for significant findings were less than 0.05. Parametric/nonparametric distribution was determined by performing the Kolmogorov–Smirnov test for all groups. Student's t-test was used for variables with parametric distribution and the Mann–Whitney U-test for variables with the nonparametric distribution. A cut-off level for biomarkers was determined using the ROC (receiver operator characteristic) curve. Results In the LC group, platelet, platecrit, mean platelet volume, platelet diameter width, white blood cell, lymphocyte, eosinophil, neutrophil, immature granulocyte, immature lymphocyte, immature monocyte, large immune cell, and atypical lymphocyte counts among the complete blood count parameters of mature and immature cell counts showed a significant difference according to the C and LUC groups. C-reactive protein, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and C-reactive protein-to-albumin ratio (CAR) indices were significantly elevated in LC patients and were significantly higher in patients classified as severe compared to mild. When CAR optimal cutoff was determined as 0.475, area under the curve was 0.934, sensitivity was 90.91%, specificity was 86.21%, positive predictive value was 92.59%, and negative predictive value was 83.33%. The diagnostic accuracy for CAR was 89.29%. Conclusion The CAR index with the highest diagnostic value and the highest predictability could be the most useful biomarker in the diagnosis and evaluation of disease severity in COVID-19 patients.

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Performance of a Rapid Diagnostic Test for Influenza in a Tertiary Military Hospital, Philippines

Military Medicine ◽

10.1093/milmed/usab006 ◽

2021 ◽

Cited By ~ 1

Author(s):

John Mark Velasco ◽

Maria Theresa Valderama ◽

Paula Corazon Diones ◽

Fatima Claire Navarro ◽

Maribel Develos ◽

...

Keyword(s):

Predictive Value ◽

Influenza A ◽

Clinical Symptoms ◽

Medical Center ◽

Age Groups ◽

Armed Forces ◽

The Philippines ◽

Military Hospital ◽

Ct Value ◽

Significant Difference

ABSTRACT Introduction It is important to evaluate the performance of existing rapid influenza diagnostic tests (RIDTs) and the factors that can affect performance especially when the circulation dynamics of influenza strains change such as the displacement and replacement of the circulating seasonal influenza strains. Materials and Methods Nasal swabs were collected from patients presenting at V Luna Medical Center, Armed Forces of the Philippines Health Service Command, with influenza-like illness (ILI) with one swab tested using Quickvue (QV) influenza A+B RIDT (Quidel) and the other swab tested using the ABI 7500 (Applied Biosystems) real-time reverse transcriptase-polymerase chain reaction. Sensitivity, specificity, positive predictive value, and negative predictive value were estimated. We identified clinical symptoms predictive of influenza subtype and evaluated the independence of QV sensitivity on (1) Cycle threshold (Ct) value, controlling for timing of collection; (2) timing of collection, controlling for Ct value; and (3) Ct value and timing of collection taken together. Results Between August 2011 and October 2016, patients presenting with ILI (n = 2333) underwent testing. Quickvue sensitivity across all subtypes was significantly correlated with lower Ct values (higher virus titers) (P <.001) and, except for flu A/H3 (P = .974), was also significantly associated with timing of specimen collection (P <.05). No statistically significant difference was noted in QV sensitivity for Flu A/H3 (P = .130), pandemic H1/N1 (P = .207), Flu A/H3 + pandemic H1/N1 (P = .341), and Flu B (P = .103) across different age groups but sensitivity of QV significantly differed (P <.001) across the different influenza subtypes. Conclusion Overall specificity of QV was high across all flu subtypes, but overall sensitivity was low (Flu A/pdm H1) to moderate (Flu A/H3 and Flu B). The findings highlight the need to develop more sensitive influenza RDTs to detect circulating influenza strains and the use of the quadrivalent flu vaccine during the annual influenza vaccination.

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A disease severity scale for the evaluation of vaccine and other preventive or therapeutic interventions for travellers’ diarrhoea

Journal of Travel Medicine ◽

10.1093/jtm/taab139 ◽

2021 ◽

Author(s):

Nicole Maier ◽

Mark S Riddle ◽

Ramiro Gutiérrez ◽

Jamie A Fraser ◽

Patrick Connor ◽

...

Keyword(s):

Disease Severity ◽

Severity Score ◽

Negative Impact ◽

Febrile Illness ◽

Signs And Symptoms ◽

Illness Severity ◽

Therapeutic Interventions ◽

Watery Diarrhoea ◽

Secondary Outcome ◽

Significant Difference

Abstract Background Travellers’ diarrhoea (TD) is the most common travel-related illness with an estimated 10 million people afflicted annually. Outcome measures to assess the efficacy of primary and secondary TD interventions were historically based on diarrhoea frequency with ≥1 associated gastrointestinal symptom. Furthermore, efficacy determination is often made on the presence or absence of TD, rather than on TD illness severity. Current severity classifications are based on subjective consideration of impact of illness on activity. We sought to develop a standardized scoring system to characterize TD severity to potentially apply as a secondary outcome in future field studies. Methods Data on multiple signs and symptoms were obtained from a previously published multisite TD treatment trial conducted by the US Department of Defense (TrEAT TD). Correlation, regression and multiple correspondence analyses were performed to assess impact on activity and a TD severity score was established. Results Numerous signs and symptoms were associated with impaired function, with malaise and nausea most strongly associated [odds ratio (OR) 5.9–44.3, P < 0.0001 and OR 2.8–37.1, P < 0.0001, respectively). Based on co-varying symptomatology, a TD severity score accounting for diarrhoea frequency in addition to several signs and symptoms was a better predictor of negative impact on function than any single sign/symptom (X2 = 127.16, P < 0.001). Additionally, there was a significant difference (P < 0.0001) in the mean TD severity score between those with acute watery diarrhoea (3.9 ± 1.9) and those with dysentery or acute febrile illness (6.2 ± 2.0). Conclusions The newly developed disease severity score better predicted a negative impact on activity due to TD than did any single sign or symptom. Incorporating multiple parameters into the TD severity score better captures illness severity and moves the field towards current recommendations for TD management by considering symptoms with high functional impact. Further validation of this score is needed in non-military travellers and other settings.

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Predictive value of pentraxin-3 on disease severity and prognosis in patients with hemorrhagic fever with renal syndrome

10.21203/rs.3.rs-30998/v2 ◽

2020 ◽

Author(s):

Hong Du ◽

Haifeng Hu ◽

Pingzhong Wang ◽

Xiaoyan Wang ◽

Ying Zhang ◽

...

Keyword(s):

Disease Severity ◽

Acute Phase ◽

Roc Curve ◽

Predictive Value ◽

Age Distribution ◽

Hemorrhagic Fever ◽

Enzyme Linked Immunosorbent Assay ◽

Control Group ◽

Pentraxin 3 ◽

Significant Difference

Abstract Background: Pentraxin-3 is an acute-phase protein involved in the processes of inflammation and infection. This study aimed to analyze the changes of plasma pentraxin-3 prospectively and evaluate its predictive value on disease severity and prognosis in patients with hemorrhagic fever with renal syndrome (HFRS).Methods: A total of 105 HFRS patients were enrolled in this study and were grouped according to the clinical classification criteria for HFRS, and 27 healthy volunteers served as controls. The levels of plasma pentraxin-3 were detected using the enzyme linked immunosorbent assay (ELISA), and which were compared among the acute and convalescent phases in different types of patients, as well as the control group. Spearman correlation analysis was used to evaluate the correlation between pentraxin-3 and conventional laboratory indexes. The predictive effectiveness for prognosis of pentraxin-3 was evaluated by receiver operating characteristic (ROC) curve analysis.Results: There was no significant difference in gender and age distribution between all types of patients and control group (P>0.05). In all types of patients, the levels of pentraxin-3 in acute phase were significantly higher than that of control group and convalescent phase of the same type (P<0.05). The levels of pentraxin-3 increased with the aggravation of the disease, and showed the highest expression in critical-type patients (P<0.05). Pentraxin-3 was positively correlated with WBC, AST and APTT, and negatively correlated with PLT, ALB and Fib (|rs|>0.500, P<0.001). Pentraxin-3 showed significant predictive value for the prognosis of HFRS patients, with the area under ROC curve (AUC) of 0.753 (95%CI: 0.593~0.914, P=0.003).Conclusions: The detection of plasma pentraxin-3 can be beneficial to the evaluation of disease severity and prognosis in patients with HFRS.

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Introduction of intraoperative neuromonitoring does not necessarily improve overall long-term outcome in elective aneurysm clipping

Journal of Neurosurgery ◽

10.3171/2018.12.jns182177 ◽

2020 ◽

Vol 132 (4) ◽

pp. 1188-1196 ◽

Cited By ~ 2

Author(s):

Tobias Greve ◽

Veit M. Stoecklein ◽

Franziska Dorn ◽

Sophia Laskowski ◽

Niklas Thon ◽

...

Keyword(s):

Evoked Potentials ◽

Predictive Value ◽

Neurological Outcome ◽

Positive Impact ◽

Case Series ◽

Intraoperative Neuromonitoring ◽

Neurosurgical Procedures ◽

Long Term Outcome ◽

Unruptured Intracranial Aneurysms ◽

Significant Difference

OBJECTIVEIntraoperative neuromonitoring (IOM), particularly of somatosensory-evoked potentials (SSEPs) and motor-evoked potentials (MEPs), evolved as standard of care in a variety of neurosurgical procedures. Case series report a positive impact of IOM for elective microsurgical clipping of unruptured intracranial aneurysms (ECUIA), whereas systematic evaluation of its predictive value is lacking. Therefore, the authors analyzed the neurological outcome of patients undergoing ECUIA before and after IOM introduction to this procedure.METHODSThe dates of inclusion in the study were 2007–2014. In this period, ECUIA procedures before (n = 136, NIOM-group; 2007–2010) and after introduction of IOM (n = 138, IOM-group; 2011–2014) were included. The cutoff value for SSEP/MEP abnormality was chosen as an amplitude reduction ≥ 50%. SSEP/MEP changes were correlated with neurological outcome. IOM-undetectable deficits (bulbar, vision, ataxia) were not included in risk stratification.RESULTSThere was no significant difference in sex distribution, follow-up period, subarachnoid hemorrhage risk factors, aneurysm diameter, complexity, and location. Age was higher in the IOM-group (57 vs 54 years, p = 0.012). In the IOM group, there were 18 new postoperative deficits (13.0%, 5.8% permanent), 9 hemisyndromes, 2 comas, 4 bulbar symptoms, and 3 visual deficits. In the NIOM group there were 18 new deficits (13.2%; 7.3% permanent, including 7 hemisyndromes). The groups did not significantly differ in the number or nature of postoperative deficits, nor in their recovery rate. In the IOM group, SSEPs and MEPs were available in 99% of cases. Significant changes were noted in 18 cases, 4 of which exhibited postoperative hemisyndrome, and 1 suffered from prolonged comatose state (5 true-positive cases). Twelve patients showed no new detectable deficits (false positives), however 2 of these cases showed asymptomatic infarction. Five patients with new hemisyndrome and 1 comatose patient did not show significant SSEP/MEP alterations (false negatives). Overall sensitivity of SSEP/MEP monitoring was 45.5%, specificity 89.8%, positive predictive value 27.8%, and negative predictive value 95.0%.CONCLUSIONSThe assumed positive impact of introducing SSEP/MEP monitoring on overall neurological outcome in ECUIA did not reach significance. This study suggests that from a medicolegal point of view, IOM is not stringently required in all neurovascular procedures. However, future studies should carefully address high-risk patients with complex procedures who might benefit more clearly from IOM than others.

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Limited predictive value of illness perceptions for short-term poor recovery in musculoskeletal pain. A multi-center longitudinal study

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-04366-7 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

E. J. de Raaij ◽

H. Wittink ◽

J. F. Maissan ◽

P. Westers ◽

R. W. J. G. Ostelo

Keyword(s):

Prognostic Factors ◽

Pain Intensity ◽

Musculoskeletal Pain ◽

Physical Functioning ◽

Predictive Value ◽

Illness Perceptions ◽

Illness Perception ◽

Added Value ◽

Poor Recovery ◽

Significant Difference

Abstract Background Musculoskeletal pain (MSP) is recognized worldwide as a major cause of increased years lived with disability. In addition to known generic prognostic factors, illness perceptions (IPs) may have predictive value for poor recovery in MSP. We were interested in the added predictive value of baseline IPs, over and above the known generic prognostic factors, on clinical recovery from MSP. Also, it is hypothesized there may be overlap between IPs and domains covered by the Four-Dimensional Symptom Questionnaire (4DSQ), measuring distress, depression, anxiety and somatization. The aim of this study is twofold; 1) to assess the added predictive value of IPs for poor recovery and 2) to assess differences in predictive value for poor recovery between the Brief Illness Perception Questionnaire - Dutch Language Version (Brief IPQ-DLV) and the 4DSQ. Methods An eligible sample of 251 patients with musculoskeletal pain attending outpatient physical therapy were included in a multi-center longitudinal cohort study. Pain intensity, physical functioning and Global Perceived Effect were the primary outcomes. Hierarchical logistic regression models were used to assess the added value of baseline IPs for predicting poor recovery. To investigate the performance of the models, the levels of calibration (Hosmer-Lemeshov test) and discrimination (Area under the Curve (AUC)) were assessed. Results Baseline ‘Treatment Control’ added little predictive value for poor recovery in pain intensity [Odds Ratio (OR) 0.80 (Confidence Interval (CI) 0.66–0.97), increase in AUC 2%] and global perceived effect [OR 0.78 (CI 0.65–0.93), increase in AUC 3%]. Baseline ‘Timeline’ added little predictive value for poor recovery in physical functioning [OR 1.16 (CI 1.03–1.30), increase in AUC 2%]. There was a non-significant difference between AUCs in predictive value for poor recovery between the Brief IPQ-DLV and the 4DSQ. Conclusions Based on the findings of this explorative study, assessing baseline IPs, over and above the known generic prognostic factors, does not result in a substantial improvement in the prediction of poor recovery. Also, no recommendations can be given for preferring either the 4DSQ or the Brief IPQ-DLV to assess psychological factors.

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An Experimental Evidence on Eco-Friendly Advertisement Appeals and Intention to Use Bio-Nanomaterial Plastics: Institutional Collectivism and Performance Orientation as Moderators

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18020791 ◽

2021 ◽

Vol 18 (2) ◽

pp. 791 ◽

Cited By ~ 1

Author(s):

Syed Hassan Raza ◽

Umer Zaman ◽

Moneeba Iftikhar ◽

Owais Shafique

Keyword(s):

Structural Equation ◽

Two Dimensions ◽

Cultural Dimensions ◽

Health Concern ◽

Equation Modeling ◽

Intention To Use ◽

Advertising Appeals ◽

Sustainable Solutions ◽

Performance Orientation ◽

Significant Difference

Plastic waste management has become a serious environmental and health concern owing to large amounts of plastic deposits globally. Recently, innovative and sustainable solutions have been introduced (e.g., bio-nanomaterial plastics) to overcome the growing environmental threats. Hence, green marketers need to develop effective advertising campaigns to enhance the usage of bio-nanomaterial plastics. Past literature has suggested that cultural value-laden advertising appeals can give sustainable behavioral cues to consumers. Hence, this research unfolds the underlying cultural dimensions between the value-laden eco-friendly advertising appeals and intention to use bio-nanomaterial plastics (henceforth IBP). The present study proposes a moderating model in which two dimensions presented in the Global Leadership and Organizational Behavior Effectiveness (henceforth GLOBE) framework interact with the individuals’ perception of eco-friendly advertising appeals (henceforth IPEA) to drive bio-nanomaterial plastics usage. The model was tested by conducting an experimental study on a sample of 364 Pakistani consumers. Findings of structural equation modeling show a significant difference in the relationship between IPEA and IBP, which is moderated by the performance orientation (henceforth PO) and institutional collectivism (henceforth IC) dimensions with diverse intensity. These findings validate the effectiveness of PO and IC (as cultural dimensions) and eco-friendly advertisements that can potentially promote the consumption of bio-nanomaterials plastic.

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Predictive value of time-variant color-coded multiphase CT angiography (mCTA) regarding clinical outcome of acute ischemic stroke: in comparison with conventional mCTA and CT perfusion

Acta Radiologica ◽

10.1177/0284185120981770 ◽

2020 ◽

pp. 028418512098177

Author(s):

Yu Lin ◽

Nannan Kang ◽

Jianghe Kang ◽

Shaomao Lv ◽

Jinan Wang

Keyword(s):

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Predictive Value ◽

Ct Perfusion ◽

Roc Curves ◽

Multivariate Logistic Regression Model ◽

Infarct Core ◽

Predictive Values ◽

Significant Difference ◽

Core Volume

Background Color-coded multiphase computed tomography angiography (mCTA) can provide time-variant blood flow information of collateral circulation for acute ischemic stroke (AIS). Purpose To compare the predictive values of color-coded mCTA, conventional mCTA, and CT perfusion (CTP) for the clinical outcomes of patients with AIS. Material and Methods Consecutive patients with anterior circulation AIS were retrospectively reviewed at our center. Baseline collateral scores of color-coded mCTA and conventional mCTA were assessed by a 6-point scale. The reliabilities between junior and senior observers were assessed by weighted Kappa coefficients. Receiver operating characteristic (ROC) curves and multivariate logistic regression model were applied to evaluate the predictive capabilities of color-coded mCTA and conventional mCTA scores, and CTP parameters (hypoperfusion and infarct core volume) for a favorable outcome of AIS. Results A total of 138 patients (including 70 cases of good outcomes) were included in our study. Patients with favorable prognoses were correlated with better collateral circulations on both color-coded and conventional mCTA, and smaller hypoperfusion and infarct core volume (all P < 0.05) on CTP. ROC curves revealed no significant difference between the predictive capability of color-coded and conventional mCTA ( P = 0.427). The predictive value of CTP parameters tended to be inferior to that of color-coded mCTA score (all P < 0.001). Both junior and senior observers had consistently excellent performances (κ = 0.89) when analyzing color-coded mCTA maps. Conclusion Color-coded mCTA provides prognostic information of patients with AIS equivalent to or better than that of conventional mCTA and CTP. Junior radiologists can reach high diagnostic accuracy when interpreting color-coded mCTA images.

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PREDICTIVE VALUE OF LOW AT III LEVELS FOR THE OCCURRENCE OF IVH, IRDS AND DEATH IN PREMATURE NEONATES

10.1055/s-0038-1644268 ◽

1987 ◽

Author(s):

W van den Berg ◽

M Peters ◽

C Breederveld ◽

J W ten Cate ◽

J G Koppe

Keyword(s):

Positive Predictive Value ◽

Predictive Value ◽

Distress Syndrome ◽

Peripheral Vein ◽

Premature Neonates ◽

Significant Difference ◽

At Iii ◽

Diffuse Intravascular Coagulation ◽

Idiopathic Respiratory Distress Syndrome ◽

A Prospective Study

The observation of AT III deficiency in premature neonates with Idiopathic Respiratory Distress Syndrome (IRDS), suggests a positive predictive value for a poor outcome. The underlying diffuse intravascular coagulation could generate serious hemorrhagic complications like Peri/Intraventricular Hemorrhage (IVH).A prospective study was performed in consecutively born neonates to assess the predictive value of low AT III for theoccurrence of IVH, (gr. III/IV), IRDS, and death. Eighty-one neonates were included in the study during a period of 5 months. AT III levels were determined immediately after birth by a chromogenic substrate assay. Values in umbilical cord blood were identical with values in capillary or peripheral vein blood samples taken within 6 hours after birth. There was no correlation between AT III values and gestational age (r: 0.18). Twenty-four neonates with IRDS showed a mean AT III value of 0.23 U/ml (S. D. ± 0.07 U/ml) which was significantly lower than a mean AT III value of 0.35 U/ml (S. D. ± 0.1 U/ml) for neonates without IRDS (p ≺0.00005). When IVH gr. III/IV was diagnosed in neonates having IRDS (8/24) no significant difference in mean AT IIIact was observed with respect to jnean AT III levels of remaining neonates without this complication. No death occurred in neonates without IRDS. Mean AT IIIact (0.21 U/ml) in neonates with IRDS who died (9/24) was low compared with mean AT III levels of neonates with IRDS who survived (0.25 U/ml), but did not reach significance (p≻0.1). Assuming a critical value of AT III of 20% a positive predictive value of 89% for IRDS, 44% for IVH, and 56% for death was calculated. It is concluded that low AT Illact levels have a high predictive value for IRDS.

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