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Comparison of the delta neutrophil index with procalcitonin, erythrocyte sedimentation rate, and C-reactive protein as predictors of sepsis in patients with acute prostatitis

Authors
 Hyun Kyu Ahn  ;  Kyo Chul Koo  ;  Byung Ha Chung  ;  Kwang Suk Lee 
Citation
 Prostate International, Vol.6(4) : 157-161, 2018 
Journal Title
 Prostate International 
ISSN
 2287-8882 
Issue Date
2018
Keywords
AP, acute prostatitis ; AUR, acute urinary retention ; Acute bacterial prostatitis ; BPH, benign prostatic hyperplasia ; Bacteremia ; Biological markers ; CRP, C-reactive protein ; DNI, delta neutrophil index ; ESR, erythrocyte sedimentation rate ; Escherichia coli ; IPSS, International Prostate Syndrome Score ; PSA, prostate-specific antigen ; SIRS, systemic inflammatory response syndrome ; Sepsis ; WBC, white blood cell
Abstract
Background: We investigated the usefulness of inflammatory markers including the delta neutrophil index (DNI), erythrocyte sedimentation rate, C-reactive protein, and procalcitonin as early predictors of sepsis in patients with acute prostatitis (AP). In addition, we evaluated the efficacy of intermittent catheterization for the initial management of acute urinary retention (AUR) in patients with AP. Materials and methods: All patients who presented to the emergency department and were admitted to the urology department from January 2011 to December 2013 were retrospectively reviewed. The clinical features, prostate-specific antigen levels, inflammatory marker levels, and urine and blood culture results were obtained from medical records. Patients who underwent urethrocystoscopy or prostate biopsy within 7 days were excluded. Results: Of 132 patients (mean age, 64.8 years) in this cohort, 17 (12.9%) had sepsis and 22 (16.7%) had positive blood cultures. Escherichia coli was the most common isolate in blood and urine cultures. In multivariate analysis, the DNI and prostate-specific antigen were identified as predictors of sepsis. The DNI was a significant prognostic factor for bacteremia. In patients with AP, procalcitonin was not a significant predictor of sepsis. Of 19 patients with AUR, 10 needed Foley catheterization because of refractory AUR. C-reactive protein was a significant predictor of failure of the initial management of AUR. Conclusions: The DNI is useful as a predictive factor for sepsis and bacteremia in patients with AP. Without mandatory cystostomy, intermittent catheterization could be one of the useful management options of AUR in patients with AP.
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DOI
10.1016/j.prnil.2018.05.001
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
구교철(Koo, Kyo Chul) ORCID logo https://orcid.org/0000-0001-7303-6256
이광석(Lee, Kwang Suk) ORCID logo https://orcid.org/0000-0002-7961-8393
정병하(Chung, Byung Ha) ORCID logo https://orcid.org/0000-0001-9817-3660
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/166807
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