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Delta neutrophil index: a promising diagnostic and prognostic marker for sepsis

 Seok, Yoonmi  ;  Choi, Jong Rak  ;  Kim, Juwon  ;  Kim, Young Keun  ;  Lee, Jongwook  ;  Song, Jaewoo  ;  Kim, Sue Jeong  ;  Lee, Kyung-A 
 SHOCK, Vol.37(3) : 242-246, 2012 
Journal Title
Issue Date
Aged ; C-Reactive Protein/metabolism ; Female ; Humans ; Male ; Middle Aged ; Neutrophils/cytology* ; Neutrophils/enzymology ; Peroxidase/blood ; Prognosis ; ROC Curve ; Retrospective Studies ; Sepsis/blood ; Sepsis/diagnosis* ; Sepsis/mortality ; Systemic Inflammatory Response Syndrome/blood ; Systemic Inflammatory Response Syndrome/diagnosis
Automated hematology analyzer ; ADVIA 2120 ; infectious diseases ; immature granulocyte ; systemic inflammation ; C-reactive protein
Delta neutrophil index (DN) is the immature granulocyte fraction provided by a blood cell analyzer (ADVIA 2120; Siemens Healthcare Diagnostics, Deerfield, Ill), which is determined by subtracting the fraction of mature polymorphonuclear leukocytes from the sum of myeloperoxidase-reactive cells. The purpose of this study was to define the role of DN in differential diagnosis and prognosis prediction of patients with sepsis. Hospital records of 273 patients were retrospectively collected: 47 with systemic inflammatory response syndrome, 78 with sepsis, 51 with severe sepsis, and 97 control subjects. Delta neutrophil index and C-reactive protein data on the day of the first blood culture were compared among the groups, and 28-day mortality associated with sepsis was assessed. Median values of DN were 0.0% (interquartile range, 0.0%-0.0%) in the control group, 0.8% (0.0%-1.7%) in the systemic inflammatory response syndrome group, 3.4% (1.5%-5.3%) in the sepsis group, and 18.6% (9.3%-24.7%) in the severe sepsis group. Furthermore, there were significant differences among the groups. The receiver operating characteristic curves showed that DN was a better predictor of sepsis than C-reactive protein. The best cutoff value for DN for predicting sepsis was 2.7%. Delta neutrophil index was significantly higher in those who died than in the survivors (median [interquartile range], 11.5% [3.5%-25.0%] vs. 4.7% [2.2%-10.6%], P = 0.008) and was identified to be an independent predictor for 28-day mortality in patients with sepsis by Cox proportional hazards model. Delta neutrophil index may serve as a facile and useful marker for early diagnosis and prognostic assessment of patients with sepsis, as it is included in a routine complete blood count.
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1. College of Medicine (의과대학) > Dept. of Laboratory Medicine (진단검사의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Sue Jeong(김수정)
Seok, Yoon Mi(석윤미)
Song, Jae Woo(송재우) ORCID logo https://orcid.org/0000-0002-1877-5731
Lee, Kyung A(이경아) ORCID logo https://orcid.org/0000-0001-5320-6705
Choi, Jong Rak(최종락) ORCID logo https://orcid.org/0000-0002-0608-2989
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