Delta neutrophil index for predicting mortality in trauma patients who underwent emergent abdominal surgery: A case controlled study

Bang, Hyun Joo; Kim, Kwangmin; Shim, Hongjin; Kim, Seongyup; Jung, Pil Young; Choi, Young Un; Bae, Keum Seok; Kim, Ik Yong; Jang, Ji Young

doi:10.1371/journal.pone.0230149

Cited by 10 publications

(5 citation statements)

References 26 publications

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“…Recently, it was studied as a factor showing the degree of the inflammatory response due to tissue damage or haemorrhage following trauma. Another study conducted in our hospital also revealed that DNI was associated with mortality among patients undergoing surgery due to abdominal trauma [18] . In this study, DNI was not associated with failed CMO in BRI patients.…”

Section: Discussionmentioning

confidence: 53%

Determination of the radiologic findings for predicting failure of conservative management with observation for blunt renal injury patients: A single-centre experience over 13 years

Kim

Jang

et al. 2021

Injury

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Most blunt renal injuries (BRIs) are managed conservatively without complications. Because conservative management with observation (CMO) is widely conducted, failed CMO is frequent. Clarifying the role and indication of CMO is important to manage BRI patients. Therefore, this study was conducted to analyse factors related to failed CMO.Methods: BRI patients (aged > 13 years) who were admitted via the emergency department in Wonju Severance Christian Hospital were analysed retrospectively between January 2008 and July 2020. Patient characteristics, including clinical data, laboratory findings, transfusion requirements, injury grade, initial CT findings, length of hospital stay, intensive care unit stay, and mortality, were investigated for all enrolled patients.Results: Kidney injury grade ≥ 4, perinephric haematoma rim distance (PHD), length of main laceration, intravascular contrast extravasation (ICE), Gerota's fascia discontinuity, multiple lacerations, dissociated renal fragment and complexity of laceration were statistically significantly different between the successful CMO and failed CMO groups in the comparative analysis.The multivariate analysis showed that perinephric haematoma rim distance [odds ratio (OR) 1.44 [95% confidence interval (CI) 1.09 -1.90], p = 0.011] and ICE , p = 0.001] were mutually independent risk factors associated with failed CMO.When the ROC curve of PHD and ICE was generated to predict the failure of CMO, the area under the curve (AUC) was 0.884 (95% CI, 0.826 -0.942), p < 0.001), and the optimal cut-off value for PHD was 2.9 cm, and for ICE was presence of ICE on CT [sensitivity: 90.5% (95% CI, 0.70 -0.99), specificity: 78.0% (95% CI, 0.73 -0.83)]. Conclusion:PHD and ICE may be useful factors to predict failed CMO for BRI patients. PHD > 2.9 cm and the presence of ICE may indicate who will require invasive procedures. Close observation is wise for patients with these risk factors.

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Section: Discussionmentioning

confidence: 53%

Determination of the radiologic findings for predicting failure of conservative management with observation for blunt renal injury patients: A single-centre experience over 13 years

Kim

Jang

et al. 2021

Injury

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“…There is a difference in DNI between the SIRS group and non-SIRS with a p-value <0.05. Research Bang et al (2020) found there was a significant difference in DNI with postoperative outcomes [30].…”

Section: Resultsmentioning

confidence: 99%

Elevated Delta Neutrophil Index (DNI) as a Predictor of Systemic Inflammatory Response Syndrome (SIRS) In Patients with Generalized Peritonitis at Prof Dr. I.G.N.G. Ngoerah Hospital, Denpasar

Mahartha,

Peridijaya,

Lestari

2024

International Journal of Scientific Advances

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Background: Generalized peritonitis is an emergency case in the field of surgery. Which includes an inflammatory process in the peritoneum. Systemic inflammatory response syndrome (SIRS) is a defense response to a stressor. Delta Neutrophil Index (DNI) is a parameter that reflects the ratio of infection and inflammation. This study examines the role of DNI as a predictor of SIRS in generalized peritonitis patients at Prof. Dr. IGNG Ngoerah General Hospital. Method: Cross-sectional analytic observational research. Data collection was from July 2022 to October 2022. Patients diagnosed with generalized peritonitis were taken for blood samples. The DNI examination was carried out at the Surya Husadha Hospital Laboratory. Samples were excluded if they suffered from immunodeficiency diseases, autoimmune diseases and refused to participate. The DNI value is determined by the cut-off point on the ROC curve. Bivariate analysis using Chi square test and multivariate analysis using logistic regression test. The p value <0.05 indicates a significant result. Result: This study involved 55 respondents with 41 positive SIRS respondents and 14 negative SIRS respondents. ROC curve analysis showed the DNI value with a cut-off point of 8.9 (sensitivity 85.4% and specificity 85.7%). Bivariate analysis of the DNI 8.9 with the incidence of SIRS obtained RR 3 (p = 0.000; 95% C1 1.11- 6.90). Multivariate analysis of DNI values with the incidence of SIRS showed a significant relationship (p = 0.000). Conclusion: DNI value of 8.9 is an excellent predictor of SIRS in patients with generalized peritonitis.

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“…The DNI is a numerical value indicating the degree of infection as well as the degree of acute inflammatory response resulting from trauma-induced tissue damage and hemorrhage [21]. Therefore, a higher DNI would be expected in the BUIpresent group, reflecting more severe tissue damage due to BUI, compared with the BUI-absent group.…”

Section: Discussionmentioning

confidence: 99%

Determination of Risk Factors for Predicting Bladder-Urethra Injury in Cases of Pelvic Bone Fracture: A Retrospective Single Center Study

Kim

Choi

et al. 2022

J Acute Care Surg

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Purpose: Pelvis fractures are associated with bladder and urethral injury (BUI). The purpose of this study was to identify risk factors associated with BUI in patients with pelvic fracture.Methods: Patients (> 18 years) with pelvic injury (N = 314) at our hospital between January 2015 and June 2020 were retrospectively analyzed for age, sex, cause of injury, initial vital signs, urine red blood cell (RBC) count, Glasgow Coma Scale and Abbreviated Injury Scale score, Injury Severity Score, preperitoneal pelvic packing, and femur, lumbar spine, and pelvic fractures.Results: Compared with the BUI-absent group, the BUI-present group had a greater percentage of patients who were male (79.2% vs. 55.9%; p = 0.026), had a urine RBC count/high power field (HPF) ≥ 30 (94.4% vs. 38.8%; p < 0.001), underwent preperitoneal pelvic packing (37.5% vs. 18.6%; p = 0.035), had symphysis pubis diastasis (33.3% vs. 11.7%; p = 0.008), and had sacroiliac joint dislocation (54.2% vs. 23.4%; p = 0.001). Independent risk factors associated with BUI were symphysis pubis diastasis [odds ratio (OR) was 3.958 (95% confidence interval: 1.191–13.154); p = 0.025] and a urine RBC count/HPF ≥ 30 [OR = 25.415 (95% confidence interval: 3.252–198.637); p = 0.006]. Of those with BUI, 15 patients were diagnosed at the trauma bay, and 9 had a delayed diagnosis.Conclusion: Patients with pelvic injury who display symphysis pubis diastasis or have a urine RBC count/ HPF ≥ 30 are at higher risk of BUI, therefore, further BUI investigations should be considered.

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Delta neutrophil index for predicting mortality in trauma patients who underwent emergent abdominal surgery: A case controlled study

Abstract: Background Delta neutrophil index (DNI) can be used as a biomarker for infection to predict patient outcomes. We aimed to investigate the relationship between DNI and clinical outcomes in trauma patients who underwent abdominal surgery.

Cited by 10 publications

References 26 publications

Determination of the radiologic findings for predicting failure of conservative management with observation for blunt renal injury patients: A single-centre experience over 13 years

Determination of the radiologic findings for predicting failure of conservative management with observation for blunt renal injury patients: A single-centre experience over 13 years

Elevated Delta Neutrophil Index (DNI) as a Predictor of Systemic Inflammatory Response Syndrome (SIRS) In Patients with Generalized Peritonitis at Prof Dr. I.G.N.G. Ngoerah Hospital, Denpasar

Determination of Risk Factors for Predicting Bladder-Urethra Injury in Cases of Pelvic Bone Fracture: A Retrospective Single Center Study

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