Delta neutrophil index: A promising diagnostic and prognostic marker for sepsis

Yoonmi Seok, Jong Rak Choi, Juwon Kim, Young Keun Kim, Jongwook Lee, Jaewoo Song, Sue Jeong Kim, Kyung A. Lee

Research output: Contribution to journalArticle

64 Citations (Scopus)

Abstract

Delta neutrophil index (DN) is the immature granulocyte fraction provided by a blood cell analyzer (ADVIA 2120; Siemens Healthcare Diagnostics, Deerfield, Ill), which is determined by subtracting the fraction of mature polymorphonuclear leukocytes from the sum of myeloperoxidase-reactive cells. The purpose of this study was to define the role of DN in differential diagnosis and prognosis prediction of patients with sepsis. Hospital records of 273 patients were retrospectively collected: 47 with systemic inflammatory response syndrome, 78 with sepsis, 51 with severe sepsis, and 97 control subjects. Delta neutrophil index and C-reactive protein data on the day of the first blood culture were compared among the groups, and 28-day mortality associated with sepsis was assessed. Median values of DN were 0.0% (interquartile range, 0.0%-0.0%) in the control group, 0.8% (0.0%-1.7%) in the systemic inflammatory response syndrome group, 3.4% (1.5%-5.3%) in the sepsis group, and 18.6% (9.3%-24.7%) in the severe sepsis group. Furthermore, there were significant differences among the groups. The receiver operating characteristic curves showed that DN was a better predictor of sepsis than C-reactive protein. The best cutoff value for DN for predicting sepsis was 2.7%. Delta neutrophil index was significantly higher in those who died than in the survivors (median [interquartile range], 11.5% [3.5%-25.0%] vs. 4.7% [2.2%-10.6%], P = 0.008) and was identified to be an independent predictor for 28-day mortality in patients with sepsis by Cox proportional hazards model. Delta neutrophil index may serve as a facile and useful marker for early diagnosis and prognostic assessment of patients with sepsis, as it is included in a routine complete blood count.

Original languageEnglish
Pages (from-to)242-246
Number of pages5
JournalShock
Volume37
Issue number3
DOIs
Publication statusPublished - 2012 Mar 1

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Sepsis
Neutrophils
Systemic Inflammatory Response Syndrome
C-Reactive Protein
Blood Cell Count
Mortality
Hospital Records
Proportional Hazards Models
Granulocytes
ROC Curve
Peroxidase
Survivors
Early Diagnosis
Blood Cells
Differential Diagnosis
Delivery of Health Care
Control Groups

All Science Journal Classification (ASJC) codes

  • Emergency Medicine
  • Critical Care and Intensive Care Medicine

Cite this

Seok, Yoonmi ; Choi, Jong Rak ; Kim, Juwon ; Kim, Young Keun ; Lee, Jongwook ; Song, Jaewoo ; Kim, Sue Jeong ; Lee, Kyung A. / Delta neutrophil index : A promising diagnostic and prognostic marker for sepsis. In: Shock. 2012 ; Vol. 37, No. 3. pp. 242-246.
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abstract = "Delta neutrophil index (DN) is the immature granulocyte fraction provided by a blood cell analyzer (ADVIA 2120; Siemens Healthcare Diagnostics, Deerfield, Ill), which is determined by subtracting the fraction of mature polymorphonuclear leukocytes from the sum of myeloperoxidase-reactive cells. The purpose of this study was to define the role of DN in differential diagnosis and prognosis prediction of patients with sepsis. Hospital records of 273 patients were retrospectively collected: 47 with systemic inflammatory response syndrome, 78 with sepsis, 51 with severe sepsis, and 97 control subjects. Delta neutrophil index and C-reactive protein data on the day of the first blood culture were compared among the groups, and 28-day mortality associated with sepsis was assessed. Median values of DN were 0.0{\%} (interquartile range, 0.0{\%}-0.0{\%}) in the control group, 0.8{\%} (0.0{\%}-1.7{\%}) in the systemic inflammatory response syndrome group, 3.4{\%} (1.5{\%}-5.3{\%}) in the sepsis group, and 18.6{\%} (9.3{\%}-24.7{\%}) in the severe sepsis group. Furthermore, there were significant differences among the groups. The receiver operating characteristic curves showed that DN was a better predictor of sepsis than C-reactive protein. The best cutoff value for DN for predicting sepsis was 2.7{\%}. Delta neutrophil index was significantly higher in those who died than in the survivors (median [interquartile range], 11.5{\%} [3.5{\%}-25.0{\%}] vs. 4.7{\%} [2.2{\%}-10.6{\%}], P = 0.008) and was identified to be an independent predictor for 28-day mortality in patients with sepsis by Cox proportional hazards model. Delta neutrophil index may serve as a facile and useful marker for early diagnosis and prognostic assessment of patients with sepsis, as it is included in a routine complete blood count.",
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Delta neutrophil index : A promising diagnostic and prognostic marker for sepsis. / Seok, Yoonmi; Choi, Jong Rak; Kim, Juwon; Kim, Young Keun; Lee, Jongwook; Song, Jaewoo; Kim, Sue Jeong; Lee, Kyung A.

In: Shock, Vol. 37, No. 3, 01.03.2012, p. 242-246.

Research output: Contribution to journalArticle

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T1 - Delta neutrophil index

T2 - A promising diagnostic and prognostic marker for sepsis

AU - Seok, Yoonmi

AU - Choi, Jong Rak

AU - Kim, Juwon

AU - Kim, Young Keun

AU - Lee, Jongwook

AU - Song, Jaewoo

AU - Kim, Sue Jeong

AU - Lee, Kyung A.

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