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Which patients with intestinal obstruction need surgery? The delta neutrophil index as an early predictive marker

Authors
 Haemin Lee  ;  Im-Kyung Kim  ;  Man Ki Ju 
Citation
 ANNALS OF SURGICAL TREATMENT AND RESEARCH, Vol.93(5) : 272-276, 2017 
Journal Title
ANNALS OF SURGICAL TREATMENT AND RESEARCH
ISSN
 2288-6575 
Issue Date
2017
Keywords
Delta neutrophil index ; Postoperative intestinal obstruction ; Surgical intervention
Abstract
Purpose: Predicting the need for surgical intervention among patients with intestinal obstruction is challenging. The delta neutrophil index (DNI) has been suggested as a useful marker of immature granulocytes, which indicate an infection or sepsis. In this study, we evaluated the impact of the DNI as an early predictor of operation among patients with intestinal obstruction.

Methods: A total of 171 patients who were diagnosed with postoperative intestinal obstruction were enrolled in this study. Medical records, including data for the initial CRP level, WBC count, and DNI were reviewed. Receiver operating characteristic (ROC) curves were generated to clarify the optimal DNI cutoff values for predicting an operation.

Results: Among the 171 patients, 38 (22.2%) needed surgical intervention. The areas under the initial CRP, WBC, and DNI ROC curves were 0.460, 0.449, and 0.543, respectively. The optimal cutoff value for predicting further surgical intervention according to the initial DNI level was 4.3%. The accuracy of the cutoff value was 74.9%, the sensitivity was 23.7%, and the specificity was 89.5% (positive predictive value, 23.7%; negative predictive value, 89.5%). In the multivariate analysis, initial DNI levels ≥ 4.3% were significantly associated with surgical intervention (odd ratio, 3.092; 95% confidence interval, 1.072-8.918; P = 0.037).

Conclusion: The initial DNI level in patients with intestinal obstruction may be a useful predictor for determining the need for surgical intervention.
Files in This Item:
T201704781.pdf Download
DOI
10.4174/astr.2017.93.5.272
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Im Kyung(김임경) ORCID logo https://orcid.org/0000-0001-8505-5307
Lee, Haemin(이해민)
Joo, Man Ki(주만기) ORCID logo https://orcid.org/0000-0002-4112-7003
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/161426
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