Use of the delta neutrophil Index as a prognostic factor of mortality in patients with spontaneous bacterial peritonitis: Implications of a simple and useful marker

Tae Seop Lim, Beom Kyung Kim, Jong Wook Lee, Young Ki Lee, Sooyun Chang, Seung Up Kim, Do Young Kim, Sang Hoon Ahn, Kwang Hyub Han, Chae Yoon Chon, Jun Yong Park

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17 Citations (Scopus)

Abstract

Background: Spontaneous bacterial peritonitis (SBP) is a common and life-threatening infection in patients with advanced cirrhosis. The prognostic value of a novel marker, the delta neutrophil index (DNI), was investigated relative to mortality in patients with SBP. Materials & Methods: Seventy-five patients with SBP were studied from April 2010 to May 2012. DNI at initial diagnosis of SBP was determined and compared with 30-day mortality rates. Results: Of the patients, 87.7% were men, and the median age of all patients was 59.0 yrs. The area under the receiveroperating characteristic (ROC) curve of DNI for 30-day mortality was 0.701 (95% confidence interval [CI], 0.553-0.849; p = 0.009), which was higher than that of C-reactive protein (0.640, 95% CI, 0.494-0.786; p = 0.076) or the model for endstage liver disease score (0.592, 95% CI, 0.436-0.748; p = 0.235). From the ROC curve, with the sum of sensitivity and specificity, the cutoff value of DNI was determined to be 5.7%. In the high-DNI group (DNI ≥5.7%), septic shock and 30-day mortality were more prevalent compared with the low-DNI group (84.2% vs. 48.2%, p = 0.007; 57.9% vs. 14.3%, p<0.001, respectively). Patients with an elevated DNI had a higher risk of 30-day mortality compared with those with a low DNI (4.225, 95% CI, 1.631-10.949; p = 0.003). Conclusion: A higher DNI at the time of SBP diagnosis is an independent predictor of 30-day mortality in patients with SBP.

Original languageEnglish
Article numbere86884
JournalPloS one
Volume9
Issue number1
DOIs
Publication statusPublished - 2014 Jan 23

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)
  • General

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