Delta neutrophil index as a prognostic factor for mortality in patients with Fournier's gangrene

Abstract

Objectives The delta neutrophil index represents the fraction of circulating immature granulocytes and is a marker of infection and sepsis. Our study aimed to evaluate the usefulness of the delta neutrophil index in predicting mortality in patients with Fournier's gangrene. Methods We enrolled patients with Fournier's gangrene who were admitted to the Wonju Severance Christian Hospital (Wonju, Korea) between September 2010 and December 2021. We retrospectively analyzed the patients' characteristics, factors related to management, scoring systems such as the Fournier's Gangrene Severity Index, and laboratory data measured at initial presentation. Results There were 58 (68.2%) survivors and 27 (31.8%) non‐survivors. The initial levels of serum lactate, hemoglobin, delta neutrophil index, albumin, international normalized ratio, creatinine, Fournier's Gangrene Severity Index, Uludag Fournier's Gangrene Severity Index, and prognostic nutritional index differed between survivors and non‐survivors. Age, international normalized ratio, and delta neutrophil index were independent predictors of mortality in Fournier's gangrene. In receiver operating characteristic curve analysis, delta neutrophil index on the day of admission was the best indicator of mortality (area under the curve, 0.804; 95% confidence interval [0.679–0.929]). The optimal cutoff for delta neutrophil index in predicting mortality was 11.25% (sensitivity, 74.1%; specificity, 91.4%). The initial delta neutrophil index was the best indicator of mortality (area under the curve, 0.804; 95% confidence interval 0.679–0.929). Conclusion The delta neutrophil index can be useful for predicting mortality in patients with Fournier's gangrene. A delta neutrophil index >11.25% at initial presentation is a reliable predictor of Fournier's gangrene.

Unraveling the clinical significance and prognostic value of the neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, systemic immune-inflammation index, systemic inflammation response index, and delta neutrophil index

“…Most of the studies examined the usefulness of the DNI to predict various outcomes in patients with inflammation-related diseases such as cholecystitis, pancreatitis, abscess, and Fournier’s Gangrene, demonstrating similar results. [ 136 137 138 139 140 ] Nevertheless, given that these studies typically have a single-center focus and involve a limited number of patients, it is important to replicate these findings in diverse settings to obtain a definitive conclusion.…”

Biomarkers to predict mortality in patients with Fournier’s gangrene admitted to the intensive care unit after surgery in South Korea

“…The DNI is derived by quantifying the variance between leukocyte differentials measured in the myeloperoxidase and lobularity/nuclear density channels, providing an indication of the proportion of immature granulocytes present in the bloodstream [ 21 ]. Numerous studies have demonstrated that the DNI can serve as a valuable biomarker in predicting disease severity and prognosis in patients with diverse infectious conditions or sepsis [ 3 , 22 , 23 ]. However, the DNI was not an independent predictor in this study, although it was significantly higher in nonsurvivors in the univariate analysis.…”

“…It is also known as necrotizing fasciitis of the perineum and can be life-threatening if left untreated. This condition is more common in men than in women [ 2 ], and usually occurs in people with weakened immune systems or other underlying health conditions [ 3 ]. It is often caused by bacteria such as Escherichia coli , Klebsiella , and Pseudomonas aeruginosa [ 4 ].…”

“…Although many studies have evaluated biomarkers to predict disease prognosis [ 3 , 6 - 8 ], relatively fewer studies have evaluated patients admitted to the intensive care unit (ICU) after surgery. Although patients admitted to the ICU receive medically advanced management, the mortality rate associated FG is still high.…”

Endometriyal Kanserde Delta Nötrofil İndeksinin Öngörücü Potansiyeli: Tanı için Yeni Bir Biyobelirteç

“…DNI is a laboratory parameter that measures the difference between the fraction of immature granulocytes and mature granulocytes in the bloodstream (8)(9)(10). DNI is a sensitive marker of systemic inflammation and infection and has been shown to be a promising prognostic biomarker in various cancers, including EC (10)(11)(12)(13)(14). Furthermore, DNI can be used as a predictive biomarker for the development of EC in women with endometrial hyperplasia.…”