The Diagnostic Value of the Neutrophil Left Shift in Predicting Inflammatory and Infectious Disease

Seebach, Jörg Dieter; Morant, Rudolf; Rüegg, Regula; Seifert, Burkhardt; Fehr, Jörg

doi:10.1093/ajcp/107.5.582

Cited by 103 publications

(80 citation statements)

References 15 publications

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“…Toxic changes such as vacuolisation and the presence of Dohle bodies occur in infectious diseases and have been associated with high levels of CRP. 16 However, morphological changes in neutrophils, such as TG, have a high sensitivity (80%) for predicting infection. 16 A combination of more than one neutrophil left-shift parameter will increase the sensitivity.…”

Section: 9mentioning

confidence: 99%

“…16 However, morphological changes in neutrophils, such as TG, have a high sensitivity (80%) for predicting infection. 16 A combination of more than one neutrophil left-shift parameter will increase the sensitivity. 3 The relationship between infectious diseases and TG has been recognised for many years; however, the efficacy of grading the intensity of TG in predicting infectious or inflammatory conditions is controversial.…”

Section: 9mentioning

confidence: 99%

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The correlation between C-reactive protein and toxic granulation of neutrophils in the peripheral blood

Vyver

Delport

et al. 2010

S Afr Med J

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Section: 9mentioning

confidence: 99%

Section: 9mentioning

confidence: 99%

The correlation between C-reactive protein and toxic granulation of neutrophils in the peripheral blood

Vyver

Delport

et al. 2010

S Afr Med J

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“…Although an elevated WBC is a widely acknowledged and utilized measure for infection [2][3][4][5] and criteria for systemic inflammatory response syndrome (SIRS) or sepsis [6], the standard breakdown of the WBC does not include the band count, or immature neutrophil count, unless specifically requested by the physician. This is partially because the utility in adult patients is contested and highly variable.…”

Section: Introductionmentioning

confidence: 99%

Clinical outcomes of ED patients with bandemia

Shi¹,

Vilke²,

Coyne³

et al. 2015

The American Journal of Emergency Medicine

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Background: Although an elevated white blood cell count is a widely utilized measure for evidence of infection and an important criterion for evaluation of systemic inflammatory response syndrome, its component band count occupies a more contested position within clinical emergency medicine. Recent studies indicate that bandemia is highly predictive of a serious infection, suggesting that clinicians who do not appreciate the value of band counts may delay diagnosis or overlook severe infections. Objectives: Whereas previous studies focused on determining the quantitative value of the band count (ie, determining sensitivity, threshold for bandemia, etc.), this study directs attention to patient-centered outcomes, hypothesizing that the degree of bandemia predisposes patients to subsequent negative clinical outcomes associated with underappreciated severe infections. Methods: This retrospective study of electronic medical records includes patients who initially presented to the emergency department (ED) with bandemia and were subsequently discharged from the ED. These patients were screened for repeat ED visits within 7 days and death within 30 days. Results: In patients with severe bandemia who were discharged from the ED, there was a 20.9% revisit rate at 7 days and a 4.9% mortality rate at 30 days, placing severely bandemic patients at 5 times significantly greater mortality compared to nonbandemic patients (P = .032). Conclusion: Our review of patient outcomes suggests that the degree of bandemia, especially in the setting of concurrent tachycardia or fever, is associated with greater likelihood of negative clinical outcomes.

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“…[22][23][24][25][26][27] Recent studies have examined its ability to predict infectious conditions. 22,23,28,29 In this study, we investigated the usefulness of DNI as an early predictor of appendiceal perforation in elderly patients.…”

mentioning

confidence: 99%

Delta neutrophil index: A reliable marker to differentiate perforated appendicitis from non‐perforated appendicitis in the elderly

Shin

Cho

Kim

et al. 2017

Clinical Laboratory Analysis

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Background Delta neutrophil index (DNI) is a new inflammatory marker and the present study aimed to evaluate the predictive value of the DNI for the presence of a perforation in elderly with acute appendicitis. Methods This retrospective observational study was conducted on 108 consecutive elderly patients (≥65 years old) with acute appendicitis treated over a 24‐month period. Results Sixty‐nine of the 108 patients (median, IQR: 72, 67‐77 years) were allocated to the perforated appendicitis group (63.9%) and 39 to the non‐perforated appendicitis group (36.1%). WBC, neutrophil‐to‐lymphocyte ratio, platelet‐to‐lymphocyte ratio and DNI were significantly higher in the perforated group. In multiple logistic regression analyses, initial DNI was the only independent marker that can significantly predict the presence of perforation in multiple regression [odds ratio 9.38, 95% confidence interval (2.51‐35.00), P=.001]. Receiver operator characteristic curve analysis showed that DNI is a good predictor for the presence of appendiceal perforation at an optimal cut‐off for DNI being 1.4% (sensitivity 67.7%, specificity 90.0%, AUC 0.807). Conclusion Clinicians can reliably differentiate acute perforated appendicitis from non‐perforated appendicitis by DNI level of 1.4 or more in elderly patients.

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The Diagnostic Value of the Neutrophil Left Shift in Predicting Inflammatory and Infectious Disease

Abstract: T h e D i a g n o s t i c V a l u e o f t h e N e u t r o p h i l L e f t S h i f t i n P r e d i c t i n g I n f l a m m a t o r y a n d I n f e c t i o u s D i s e a s e

Cited by 103 publications

References 15 publications

The correlation between C-reactive protein and toxic granulation of neutrophils in the peripheral blood

The correlation between C-reactive protein and toxic granulation of neutrophils in the peripheral blood

Clinical outcomes of ED patients with bandemia

Delta neutrophil index: A reliable marker to differentiate perforated appendicitis from non‐perforated appendicitis in the elderly

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