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응급실에 내원한 급성 신우신염 환자에서 장기 입원 기간 예측에 있어서 델타뉴트로필의 유용성

Other Titles
 Delta Neutrophil Index as a Predictive Factor of Prolonged Hospitalization in Emergency Department Patients with Acute Pyelonephritis 
Authors
 기동훈  ;  유제성  ;  이종욱  ;  이혜선  ;  이진애  ;  정성필  ;  공태영  ;  주영선  ;  고동률 
Citation
 Journal of the Korean Society of Emergency Medicine (대한응급의학회지), Vol.28(5) : 413-421, 2017 
Journal Title
 Journal of the Korean Society of Emergency Medicine (대한응급의학회지) 
ISSN
 1226-4334 
Issue Date
2017
Keywords
Pyelonephritis ; Neutrophils ; Hospitalization
Abstract
Purpose: The delta neutrophil index (DNI) corresponds to evaluated immature granulocyte counts and severity of sepsis. The aim of this study was to investigate the diagnostic value of DNI as a predictable laboratory marker for prolonged hospitalization in patients with acute pyelonephritis in the emergency department (ED). Method: We retrospectively analyzed medical records in two EDs and screened eligible adult patients who were admitted to the ED with acute pyelonephritis from July 2012 to July 2014. The DNI was calculated for all patients as a part of routine complete blood analysis, and diagnostic performance of DNI for predicting prolonged hospitalization (over 14 days) in patients with acute pyelonephritis (APN) was evaluated. Results: A total of 308 patients with APN were enrolled in the study. Among them, 89 patients (29.9%) were hospitalized for more than 14 days. The initial DNI value was significantly higher in patients with more than 14 days of hospitalization than in those with less than 14 days of hospitalization (6% vs. 2%, p<0.001). The peak value of DNI was also significantly higher in patients discharged after 14 days of hospitalization than in those discharged before 14 days (8% vs. 2%, p<0.001). Multivariate Cox proportional hazard models showed that a DNI of more than 6.3 on ED admission day (hazard ratio [HR], 0.314; 95% confidence interval [CI], 0.191-0.515, p<0.001) and on peak day (HR, 0.37; 95% CI, 0.244-0.562, p=0.028) was an independent risk factor for hospitalization over 14 days. Conclusion: DNI is potentially useful as an independent factor for predicting hospitalization for more than 14 days.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/161340
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) ; 유제성(You, Je Sung) ; 이진애(Lee, Jinae) ; 이혜선(Lee, Hye Sun) ; 정성필(Chung, Sung Pil) ; 주영선(Joo, Young Seon)
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