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응급진료센터에 내원한 기계적 장폐색 환자에서 델타 뉴트로필 지표를 이용한 30일 사망률 예측의 유용성

Other Titles
 Usefulness of Delta Neutrophil Index to Predict 30-day Mortality in Patients with Mechanical Bowel Obstruction 
Authors
 한세희  ;  유제성  ;  정성필  ;  이혜선  ;  공태영  ;  김지훈  ;  고동률  ;  주영선  ;  좌민홍  ;  박인철 
Citation
 Journal of the Korean Society of Emergency Medicine (대한응급의학회지), Vol.28(5) : 403-412, 2017 
Journal Title
 Journal of the Korean Society of Emergency Medicine (대한응급의학회지) 
ISSN
 1226-4334 
Issue Date
2017
Keywords
Delta neutrophil index ; Mechanical bowel obstruction ; Mortality
Abstract
Purpose: Mechanical bowel obstruction (MBO) is a common emergency problem resulting in high morbidity and mortality. The delta neutrophil index (DNI), reflecting the fraction of circulating immature granulocytes, is associated with increased mortality in patients with infection and/or systemic inflammation. This study was conducted to investigate the relationship between DNI and 30-day mortality in patients with MBO. Method: We retrospectively identified consecutive patients (>18 years old) with MBO admitted to the emergency department from January 1, 2013 to April 30, 2015. The diagnosis of MBO was confirmed using clinical and radiological findings. The DNI was determined on each day of hospitalization. The outcome of interest was the 30-day mortality and the prognostic value of DNI for 30-day mortality was ascertained by Cox proportional hazards model analysis. Results: A total of 518 patients with MBO were included in this study. According to multivariate Cox proportional hazard models, higher DNI at admission (hazard ratio [HR], 1.080; 95% confidence interval [CI], 1.036-1.126; p<0.001) was a strong independent predictor of short-term mortality. Among patients with MBO, a DNI >1.9% on admission (HR, 9.410; 95% CI, 2.671-33.145; p<0.001) was associated with increased 30-day mortality. Furthermore, the accuracy of DNI for predicting 30-day mortality was superior to that of other parameters. Conclusion: The DNI can be measured rapidly and simply on emergency department admission without additional cost or time burden. Increased DNI values are associated with 30-day mortality in patients with MBO.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/161319
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Emergency Medicine (응급의학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원)
Yonsei Authors
고동률(Ko, Dong Ryul) ; 공태영(Kong, Tae Young) ; 김지훈(Kim, Ji Hoon) ; 박인철(Park, In Cheol) ; 유제성(You, Je Sung) ; 이혜선(Lee, Hye Sun) ; 정성필(Chung, Sung Pil) ; 좌민홍(Choa, Min Hong) ; 주영선(Joo, Young Seon)
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