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Use of the Delta Neutrophil Index as a Prognostic Factor of Mortality in Patients with Spontaneous Bacterial Peritonitis: Implications of a Simple and Useful Marker

Authors
 Tae Seop Lim  ;  Beom Kyung Kim  ;  Jong Wook Lee  ;  Young Ki Lee  ;  Sooyun Chang  ;  Seung Up Kim  ;  Do Young Kim  ;  Sang Hoon Ahn  ;  Kwang-Hyub Han  ;  Chae Yoon Chon  ;  Jun Yong Park 
Citation
 PLOS ONE, Vol.9(1) : e86884, 2014 
Journal Title
PLOS ONE
Issue Date
2014
MeSH
Adult ; Aged ; Aged, 80 and over ; Bacterial Infections/microbiology ; Bacterial Infections/mortality* ; Bacterial Infections/pathology ; Biomarkers/analysis* ; Female ; Follow-Up Studies ; Humans ; Liver Cirrhosis/microbiology ; Liver Cirrhosis/mortality* ; Liver Cirrhosis/pathology ; Male ; Middle Aged ; Neutrophils/pathology* ; Peritonitis/microbiology ; Peritonitis/mortality* ; Peritonitis/pathology ; Prognosis ; ROC Curve ; Retrospective Studies ; Survival Rate
Abstract
BACKGROUND: Spontaneous bacterial peritonitis (SBP) is a common and life-threatening infection in patients with advanced cirrhosis. The prognostic value of a novel marker, the delta neutrophil index (DNI), was investigated relative to mortality in patients with SBP.
MATERIALS & METHODS: Seventy-five patients with SBP were studied from April 2010 to May 2012. DNI at initial diagnosis of SBP was determined and compared with 30-day mortality rates.
RESULTS: Of the patients, 87.7% were men, and the median age of all patients was 59.0 yrs. The area under the receiver-operating characteristic (ROC) curve of DNI for 30-day mortality was 0.701 (95% confidence interval [CI], 0.553-0.849; p = 0.009), which was higher than that of C-reactive protein (0.640, 95% CI, 0.494-0.786; p = 0.076) or the model for end-stage liver disease score (0.592, 95% CI, 0.436-0.748; p = 0.235). From the ROC curve, with the sum of sensitivity and specificity, the cutoff value of DNI was determined to be 5.7%. In the high-DNI group (DNI ≥5.7%), septic shock and 30-day mortality were more prevalent compared with the low-DNI group (84.2% vs. 48.2%, p = 0.007; 57.9% vs. 14.3%, p<0.001, respectively). Patients with an elevated DNI had a higher risk of 30-day mortality compared with those with a low DNI (4.225, 95% CI, 1.631-10.949; p = 0.003).
CONCLUSION: A higher DNI at the time of SBP diagnosis is an independent predictor of 30-day mortality in patients with SBP.
Files in This Item:
T201400181.pdf Download
DOI
10.1371/journal.pone.0086884
Appears in Collections:
6. Others (기타) > Dept. of Health Promotion (건강의학과) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Do Young(김도영)
Kim, Beom Kyung(김범경) ORCID logo https://orcid.org/0000-0002-5363-2496
Kim, Seung Up(김승업) ORCID logo https://orcid.org/0000-0002-9658-8050
Park, Jun Yong(박준용) ORCID logo https://orcid.org/0000-0001-6324-2224
Ahn, Sang Hoon(안상훈) ORCID logo https://orcid.org/0000-0002-3629-4624
Lee, Young Ki(이영기)
Lim, Tae Seop(임태섭) ORCID logo https://orcid.org/0000-0002-4578-8685
Chang, Soo Yun(장수연)
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/98018
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