Delta Neutrophil Index as a Prognostic Marker in the Pediatric Intensive Care Unit

Sol, In Suk; Park, Hyun Bin; Kim, Min Jung; Yoon, Seo Hee; Kim, Yoon Hee; Kim, Kyung Won; Sohn, Myung Hyun; Kim, Kyu-Earn

doi:10.4266/kjccm.2016.00171

Cited by 4 publications

(7 citation statements)

References 20 publications

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“…found that in paediatric intensive care unit(PICU) patients, as the admission DNI level increased, the ICU scoring system values also increased, and the proportion of survivors decreased. The DNI at PICU admission was also positively correlated with ICU scores, lactate and CRP levels and negatively correlated with platelet counts 15 . Similarly, we found the highest DNI value in sepsis patients in our study.…”

Section: Discussionsupporting

confidence: 83%

“…The DNI at PICU admission was also positively correlated with ICU scores, lactate and CRP levels and negatively correlated with platelet counts. 15 Similarly, we found the highest DNI value in sepsis patients in our study.…”

Section: Discussionsupporting

confidence: 75%

“…Studies comparing the DNI with these markers have been conducted in predicting infection. [14][15][16] In a study which evaluated the diagnostic and prognostic power of the DNI and CRP in paediatric sepsis, Nam et al found that CRP is not specific for sepsis, the DNI has the strongest prognostic power among WBC parameters, and the DNI has the most powerful diagnostic potential among the parameters tested. They found the cut-off level of the DNI for sepsis was 2.7, which is similar to ours (2.5).…”

Section: Discussionmentioning

confidence: 99%

“…Nonetheless, there is no perfect marker for predicting SBIs, and elevated values of the most frequently used markers, including WBC count, CRP and ANC, are not specific for SBIs. Studies comparing the DNI with these markers have been conducted in predicting infection 14–16 . In a study which evaluated the diagnostic and prognostic power of the DNI and CRP in paediatric sepsis, Nam et al .…”

Section: Discussionmentioning

confidence: 99%

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Potential and promising marker for serious bacterial infections in children: Delta neutrophil index

Yiğit

Özkaya-Parlakay

Yilmaz

et al. 2022

J Paediatrics Child Health

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Aim This study aimed to evaluate the usefulness and accuracy of the delta neutrophil index (DNI), an index expressing the number of immature granulocytes as a proportion of the total, as an inflammatory marker in predicting serious bacterial infections (SBIs). Methods Paediatric patients admitted to our hospital with fever were divided into four groups: SBI, non‐SBI, COVID‐19 and control group. White blood cell count, absolute neutrophil count, C‐reactive protein and the DNI were recorded, and their accuracy in predicting SBI was evaluated. Results Mean DNI was 4.96 ± 8.38 in the SBI group (150 patients), 0.67 ± 1.68 in the non‐SBI group (397 patients), 0.29 ± 0.99 in the COVID‐19 group (112 patients) and 0.14 ± 0.21 in the control group (102 patients). The DNI was significantly higher in the SBI group compared with the non‐SBI (P < 0.001); the non‐SBI group also had higher levels than the COVID‐19 group (P = 0.005). One percent increase in the DNI increased the SBI rate 1.36 times (odds ratio 1.36 (95% confidence interval 1.23–1.49), P < 0.001). Based on the determined cut‐off value (>2.5%), the DNI (odds ratio 6.27 (95% confidence interval 3.85–10.21), P < 0.001) significantly predicted SBIs with 90.4% specificity and 47.7% sensitivity. Conclusions SBIs in childrenare associated with an increase in DNI levels. Compared to other biomarkers, the DNI had higher specificity in predicting SBIs. The DNI may also be usefulin differentiating bacterial and non‐bacterial infections in individualclinical syndromes. Currently, there is no evidence that serum DNI aids indifferentiating COVID‐19 and upper respiratory tract infection.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionsupporting

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Potential and promising marker for serious bacterial infections in children: Delta neutrophil index

Yiğit

Özkaya-Parlakay

Yilmaz

et al. 2022

J Paediatrics Child Health

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“…Delta neutrophil index (DNI) is a hematological inflammatory marker that reflects the fraction of IGs in the circulating blood. While several studies 8,9 have demonstrated a relationship between increased levels of DNI and inflammation/infection in adults and children, only a few studies have assessed the relationship between DNI level and sepsis in neonates. 10,11 We hypothesized that there may be a marked increase in DNI in response to bacterial infection in neonates, similar to that seen in adults.…”

Section: Introductionmentioning

confidence: 99%

Delta Neutrophil Index as a Diagnostic Marker of Neonatal Sepsis

Melekoğlu

Yaşar

Keskın

2021

Journal of Pediatric Infectious Diseases

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Objective Sepsis diagnosis is challenging due to nonspecific symptomatology in newborns. Timely diagnosis is essential for reducing sepsis-related morbidity and mortality. This study was performed to determine the diagnostic value of the delta neutrophil index (DNI) for detection of neonatal sepsis and to compare its efficacy with other conventional markers. Methods This study was conducted at a tertiary hospital in newborns with confirmed sepsis (n = 59), suspected sepsis (n = 46), and in age- and weight-matched controls (n = 49). DNI, white blood cell count, C-reactive protein (CRP) level, and platelet measurements were determined, and blood cultures were performed at the onset of symptoms. Results The mean DNI was significantly higher in confirmed and clinical sepsis groups compared with the control group. (6.9 ± 9.3, 1.9 ± 2.1, and 0.4 ± 0.5, respectively, p < 0.001). ROC curve analysis also showed that the combination of DNI and CRP had the highest sensitivity (86%), specificity (100%), and positive predictive value (100%) for predicting neonatal sepsis. DNI values were significantly higher in nonsurvivors (p < 0.05). Conclusion DNI could be used as a reliable diagnostic marker for neonatal sepsis, and high DNI could predict sepsis development and unfavorable outcomes. The diagnostic capability of DNI may be increased by assessing CRP measurements simultaneously.

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Prognostic value of the delta neutrophil index in pediatric cardiac arrest

Yoon

Lee

et al. 2020

Sci Rep

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The delta neutrophil index (DNI), which reflects the ratio of circulating immature neutrophils, has been reported to be highly predictive of mortality in systemic inflammation. We investigated the prognostic significance of DNI value for early mortality and neurologic outcomes after pediatric cardiac arrest (CA). We retrospectively analyzed the data of eligible patients (<19 years in age). Among 85 patients, 55 subjects (64.7%) survived and 36 (42.4%) showed good outcomes at 30 days after CA. Cox regression analysis revealed that the DNI values immediately after the return of spontaneous circulation, at 24 hours and 48 hours after CA, were related to an increased risk for death within 30 days after CA (P < 0.001). A DNI value of higher than 3.3% at 24 hours could significantly predict both 30-day mortality (hazard ratio: 11.8; P < 0.001) and neurologic outcomes (odds ratio: 8.04; P = 0.003). The C statistic for multivariable prediction models for 30-day mortality (incorporating DNI at 24 hours, compression time, and serum sodium level) was 0.799, and the area under the receiver operating characteristic curve of DNI at 24 hours for poor neurologic outcome was 0.871. Higher DNI was independently associated with 30-day mortality and poor neurologic outcomes after pediatric CA.

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Delta Neutrophil Index as a Prognostic Marker in the Pediatric Intensive Care Unit

Cited by 4 publications

References 20 publications

Potential and promising marker for serious bacterial infections in children: Delta neutrophil index

Potential and promising marker for serious bacterial infections in children: Delta neutrophil index

Delta Neutrophil Index as a Diagnostic Marker of Neonatal Sepsis

Prognostic value of the delta neutrophil index in pediatric cardiac arrest

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