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응급진료센터에 내원한 지역획득 폐렴 환자에서 델타뉴트로필을 이용한 패혈성 쇼크 발생 예측의 유용성

Other Titles
 Usefulness of Delta Neutrophil Index in Prediction of Septic Shock in Patients with Community-acquired Pneumonia. 
Authors
 주영선  ;  이누가  ;  김현종  ;  유제성  ;  정현수  ;  정성필  ;  이한식  ;  이종욱 
Citation
 Journal of the Korean Society of Emergency Medicine (대한응급의학회지), Vol.24(2) : 181-187, 2013 
Journal Title
 Journal of the Korean Society of Emergency Medicine (대한응급의학회지) 
ISSN
 1226-4334 
Issue Date
2013
Keywords
Septic shock ; Community-Acquired Infections ; Pneumonia ; Neutrophils ; Granulocytes
Abstract
Purpose: The delta neutrophil index (DNI) corresponds to the calculated immature granulocyte counts and the severity of sepsis. The aim of this study was to investigate the diagnostic value of DNI as a predictable laboratory marker for septic shock in patients with severe community-acquired pneumonia in emergency department. Methods: The present study was a retrospective analysis of patients with pathologically confirmed communityacquired pneumonia from December 2011 to February 2012 at a hospital. The DNI was automatically calculated as a subset of routine complete blood count test. The diagnostic performance of DNI for septic shock in patients with community-acquired pneumonia was evaluated. Results: During the study period, 105 patients were enrolled. Among them, 27 patients (25.7%) were confirmed as having septic shock according to predetermined criteria. The initial value of DNI was significantly higher in septic shock group than in non-shock group (8.7% vs 2.3%, p=0.008). The peak value of DNI was also significantly higher in septic shock group (18.6% vs 4%, p<0.001). The sensitivity and specificity of the initial and peak DNI values for predicting septic shock in patients with communityacquired pneumonia were 48.2%, 96.2%, 74.1%, and 87.2%, respectively, at initial and peak cutoff levels of 11.2% and 8.7% with an area under the curve (AUC) of 0.72 and 0.81 on the Receiver Operating Characteristic (ROC) curve. The AUC to predict septic shock was 0.74 for the CURB-65 scale. The AUC was significantly increased when peak DNI was added to CURB-65 scale (p=0.007). Conclusion: This study suggested that the DNI is associated with septic shock in patients with community-acquired pneumonia. Clinically, the peak value of DNI added to CURB-65 scale could improve predictable performance of septic shock in patients with community-acquired pneumonia.
Full Text
http://kiss.kstudy.com/journal/thesis_name.asp?tname=kiss2002&key=3142424
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Emergency Medicine (응급의학교실) > 1. Journal Papers
Yonsei Authors
You, Je Sung(유제성) ORCID logo https://orcid.org/0000-0002-2074-6745
Rhee, Nu Ga(이누가)
Lee, Hahn Shick(이한식)
Chung, Sung Pil(정성필) ORCID logo https://orcid.org/0000-0002-3074-011X
Joo, Young Seon(주영선)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/87004
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