Delta neutrophil index versus lactate clearance: Early markers for outcome prediction in septic shock patients

Zanaty, Ola M.; Megahed, Mustafa; Demerdash, Hala Mourad; Swelem, Rania

doi:10.1016/j.ajme.2012.05.003

Cited by 12 publications

(15 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… Puskarich, 2012 [ 69 ] 203 Retrospective analysis of data from [ 16 ] – 2 h, 4 h, 6 h 6 h ≥10 % decrease in lactate during resuscitation associated with decreased mortality 53. Zanaty, 2012 [ 70 ] 53 Prospective – 6 h 6 h <15 % decrease in lactate independent predictor of mortality 54. Puskarich, 2013 [ 71 ] 187 Retrospective analysis of data from [ 16 ] – At least two lactate measurements in first 6 h 6 h Lactate normalization in 6 h stronger independent predictor of survival than decrease in lactate by ≥50 % 55.…”

Section: Resultsmentioning

confidence: 99%

The value of blood lactate kinetics in critically ill patients: a systematic review

et al. 2016

View full text Add to dashboard Cite

BackgroundThe time course of blood lactate levels could be helpful to assess a patient’s response to therapy. Although the focus of published studies has been largely on septic patients, many other studies have reported serial blood lactate levels in different groups of acutely ill patients.MethodsWe performed a systematic search of PubMed, Science Direct, and Embase until the end of February 2016 plus reference lists of relevant publications. We selected all observational and interventional studies that evaluated the capacity of serial blood lactate concentrations to predict outcome. There was no restriction based on language. We excluded studies in pediatric populations, experimental studies, and studies that did not report changes in lactate values or all-cause mortality rates. We separated studies according to the type of patients included. We collected data on the number of patients, timing of lactate measurements, minimum lactate level needed for inclusion if present, and suggested time interval for predictive use.ResultsA total of 96 studies met our criteria: 14 in general ICU populations, five in general surgical ICU populations, five in patients post cardiac surgery, 14 in trauma patients, 39 in patients with sepsis, four in patients with cardiogenic shock, eight in patients after cardiac arrest, three in patients with respiratory failure, and four in other conditions. A decrease in lactate levels over time was consistently associated with lower mortality rates in all subgroups of patients. Most studies reported changes over 6, 12 or 24 hrs, fewer used shorter time intervals. Lactate kinetics did not appear very different in patients with sepsis and other types of patients. A few studies suggested that therapy could be guided by these measurements.ConclusionsThe observation of a better outcome associated with decreasing blood lactate concentrations was consistent throughout the clinical studies, and was not limited to septic patients. In all groups, the changes are relatively slow, so that lactate measurements every 1–2 hrs are probably sufficient in most acute conditions. The value of lactate kinetics appears to be valid regardless of the initial value.

show abstract

Section: Resultsmentioning

confidence: 99%

The value of blood lactate kinetics in critically ill patients: a systematic review

et al. 2016

View full text Add to dashboard Cite

show abstract

“…in another report, Park et al concluded that a Dni value  6.5% was a better indicator of severe sepsis/septic shock than CRP, lactate, WBC, or AnC (sensitivity 81.3%, specificity 91.0%, positive predictive value (PPV) 88.6% and negative predictive value (nPV) 84.7%) [8]. Furthermore, when Zanaty et al investigated the relationship between Dni and lactate 6-hour clearance in patients with severe sepsis and septic shock, they found that a Dni value  5.2% was significantly related to patient mortality (sensitivity 95.0%, specificity 90.0%, PPV 92.0% and nPV 95.0%) and overt DiC [20]. Unlike ADViA studies, the clinical studies of iG% were a small number, and showed heterogeneous enrollment and results.…”

Section: Discussionmentioning

confidence: 95%

Fraction of immature granulocytes reflects severity but not mortality in sepsis

Park

et al. 2014

Scandinavian Journal of Clinical and Laboratory Investigation

View full text Add to dashboard Cite

show abstract

“…In light of this, the DNI, which corresponds to the fraction of immature granulocytes in the circulating blood, has been introduced as a prognostic marker for various diseases [ 12 13 14 ], especially sepsis [ 6 7 8 15 16 ] and bacteremia [ 17 18 19 ]. Since the DNI can be easily calculated from the peripheral circulating blood by subtracting the fraction of mature PMN leukocytes from the sum of MPO-reactive cells, its correlation with patient prognosis has been well established.…”

Section: Discussionmentioning

confidence: 99%

Which patients with intestinal obstruction need surgery? The delta neutrophil index as an early predictive marker

Lee

Kim

2017

Ann Surg Treat Res

View full text Add to dashboard Cite

PurposePredicting the need for surgical intervention among patients with intestinal obstruction is challenging. The delta neutrophil index (DNI) has been suggested as a useful marker of immature granulocytes, which indicate an infection or sepsis. In this study, we evaluated the impact of the DNI as an early predictor of operation among patients with intestinal obstruction.MethodsA total of 171 patients who were diagnosed with postoperative intestinal obstruction were enrolled in this study. Medical records, including data for the initial CRP level, WBC count, and DNI were reviewed. Receiver operating characteristic (ROC) curves were generated to clarify the optimal DNI cutoff values for predicting an operation.ResultsAmong the 171 patients, 38 (22.2%) needed surgical intervention. The areas under the initial CRP, WBC, and DNI ROC curves were 0.460, 0.449, and 0.543, respectively. The optimal cutoff value for predicting further surgical intervention according to the initial DNI level was 4.3%. The accuracy of the cutoff value was 74.9%, the sensitivity was 23.7%, and the specificity was 89.5% (positive predictive value, 23.7%; negative predictive value, 89.5%). In the multivariate analysis, initial DNI levels ≥ 4.3% were significantly associated with surgical intervention (odd ratio, 3.092; 95% confidence interval, 1.072–8.918; P = 0.037).ConclusionThe initial DNI level in patients with intestinal obstruction may be a useful predictor for determining the need for surgical intervention.

show abstract

Delta neutrophil index versus lactate clearance: Early markers for outcome prediction in septic shock patients

Cited by 12 publications

References 19 publications

The value of blood lactate kinetics in critically ill patients: a systematic review

The value of blood lactate kinetics in critically ill patients: a systematic review

Fraction of immature granulocytes reflects severity but not mortality in sepsis

Which patients with intestinal obstruction need surgery? The delta neutrophil index as an early predictive marker

Contact Info

Product

Resources

About