The Delta Neutrophil Index as a Prognostic Marker in Patients who underwent Emergent Abdominal Surgery
Objective: The delta neutrophil index (DNI) is the fraction of circulating immature granulocytes provided by a routine, complete blood cell analyzer, which has been reported as a useful prognostic marker of sepsis. The aim of this study was to evaluate the role of the DNI in the diagnosis and prognosis of patients who had undergone emergent surgery for an acute abdomen.
Methods: A total of 694 patients for acute abdominal pain who undergone emergent abdominal surgery from May 2015 to September 2016 were retrospectively reviewed. Perioperative clinical characteristics including hospital stay, postoperative complications, and the 30-day mortality were investigated.
Results: In the analysis of the patients who underwent an operation for acute peritonitis, the DNI was a good predictor for predicting the 30-day mortality rate (Area under the curve [AUC] 0.826) and was not inferior to other laboratory values, including the activated partial thromboplastin time (AUC 0.729), C-reactive protein (AUC 0.727), albumin (AUC 0.834), prothrombin time (AUC 0.816), and creatinine (AUC 0.837) that are associated with sepsis. The patients with a high DNI (≥0.9%) displayed a higher incidence of bacteremia and sepsis, longer hospital stay, and higher postoperative complication and 30-day mortality rate. Among the patients diagnosed with acute appendicitis, the DNI was a useful marker for differentiating appendiceal perforation.
Conclusion: The DNI was a useful marker for predicting the prognosis in patients who needed emergent abdominal surgery.
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