Delta neutrophil index (DNI) as a novel diagnostic and prognostic marker of infection

a systematic review and meta-analysis

Jae Hyon Park, Hyeong Ju Byeon, Keum Hwa Lee, Jong Wook Lee, Andreas Kronbichler, Michael Eisenhut, Jaeil Shin

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Objective: Delta neutrophil index (DNI) representing the number of immature granulocytes is an emerging marker used in diagnosis of infections and prediction of mortality in infected patients. The present study evaluated the diagnostic accuracy of DNI as a predictive and prognostic factor in infected patients. Methods: We performed a PubMed search on January 1st, 2017 and identified studies that evaluated DNI as either a predictive or prognostic factor in infected patients. Studies with appropriate information to construct 2 × 2 contingency tables were extracted. We calculated pooled sensitivity and specificity. Meta-analysis of the multivariate logistic regression data set was performed to assess whether DNI functions as an independent factor. Results: Overall, 12 articles fulfilled the inclusion criteria and a total of 499 cases and 9549 controls were examined. As a predictive factor of infection, DNI’s pooled sensitivity was 0.67 (95% CI 0.62–0.71, I 2  = 86.0%) and pooled specificity was 0.94 (95% CI 0.94–0.95, I 2  = 92.8%). Area under the receiver operating characteristics (ROC) curve was 0.89. As a prognostic factor for death in infected patients, DNI’s pooled sensitivity was 0.70 (95% CI 0.56–0.81, I 2  = 0.0%) and pooled specificity was 0.78 (95% CI 0.73–0.83, I 2  = 26.6%). Area under the ROC curve was 0.84. Meta-analysis of the multivariate logistic regression data set showed insignificant results. Conclusions: DNI is a potentially useful diagnostic tool and predicts mortality among infected patients and should be more widely used in the clinical practice.

Original languageEnglish
Pages (from-to)863-870
Number of pages8
JournalInflammation Research
Volume66
Issue number10
DOIs
Publication statusPublished - 2017 Oct 1

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Meta-Analysis
Neutrophils
Infection
ROC Curve
Logistic Models
Mortality
Granulocytes
PubMed
Sensitivity and Specificity
Datasets

All Science Journal Classification (ASJC) codes

  • Immunology
  • Pharmacology

Cite this

Park, Jae Hyon ; Byeon, Hyeong Ju ; Lee, Keum Hwa ; Lee, Jong Wook ; Kronbichler, Andreas ; Eisenhut, Michael ; Shin, Jaeil. / Delta neutrophil index (DNI) as a novel diagnostic and prognostic marker of infection : a systematic review and meta-analysis. In: Inflammation Research. 2017 ; Vol. 66, No. 10. pp. 863-870.
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abstract = "Objective: Delta neutrophil index (DNI) representing the number of immature granulocytes is an emerging marker used in diagnosis of infections and prediction of mortality in infected patients. The present study evaluated the diagnostic accuracy of DNI as a predictive and prognostic factor in infected patients. Methods: We performed a PubMed search on January 1st, 2017 and identified studies that evaluated DNI as either a predictive or prognostic factor in infected patients. Studies with appropriate information to construct 2 × 2 contingency tables were extracted. We calculated pooled sensitivity and specificity. Meta-analysis of the multivariate logistic regression data set was performed to assess whether DNI functions as an independent factor. Results: Overall, 12 articles fulfilled the inclusion criteria and a total of 499 cases and 9549 controls were examined. As a predictive factor of infection, DNI’s pooled sensitivity was 0.67 (95{\%} CI 0.62–0.71, I 2  = 86.0{\%}) and pooled specificity was 0.94 (95{\%} CI 0.94–0.95, I 2  = 92.8{\%}). Area under the receiver operating characteristics (ROC) curve was 0.89. As a prognostic factor for death in infected patients, DNI’s pooled sensitivity was 0.70 (95{\%} CI 0.56–0.81, I 2  = 0.0{\%}) and pooled specificity was 0.78 (95{\%} CI 0.73–0.83, I 2  = 26.6{\%}). Area under the ROC curve was 0.84. Meta-analysis of the multivariate logistic regression data set showed insignificant results. Conclusions: DNI is a potentially useful diagnostic tool and predicts mortality among infected patients and should be more widely used in the clinical practice.",
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Delta neutrophil index (DNI) as a novel diagnostic and prognostic marker of infection : a systematic review and meta-analysis. / Park, Jae Hyon; Byeon, Hyeong Ju; Lee, Keum Hwa; Lee, Jong Wook; Kronbichler, Andreas; Eisenhut, Michael; Shin, Jaeil.

In: Inflammation Research, Vol. 66, No. 10, 01.10.2017, p. 863-870.

Research output: Contribution to journalArticle

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