The delta neutrophil index predicts development of multiple organ dysfunction syndrome and 30-day mortality in trauma patients admitted to an intensive care unit: a retrospective analysis

Abstract

No studies have examined the role of delta neutrophil index (DNI) reflecting on immature granulocytes in determining the severity of multiple organ dysfunction (MODS) and short-term mortality. This study investigated the utility of the automatically calculated DNI as a prognostic marker of severity in trauma patients who were admitted to an intensive care unit (ICU). We retrospectively analysed prospective data of eligible patients. We investigated 366 patients. On multivariable logistic regression analysis, higher DNI values at 12 h (odds ratio [OR], 1.079; 95% confidence interval [CI]: 1.037–1.123; p < 0.001) and 24 h were strong independent predictors of MODS development. Multivariable Cox regression analysis revealed that increased DNI at 12 h (hazard ratio [HR], 1.051; 95% CI, 1.024–1.079; p < 0.001) was a strong independent predictor of short-term mortality. The increased predictability of MODS after trauma was closely associated with a DNI > 3.25% at 12 h (OR, 12.7; 95% CI: 6.12–26.35; p < 0.001). A cut-off of >5.3% at 12 h was significantly associated with an increased risk of 30-day mortality (HR, 18.111; 95% CI, 6.988–46.935; p < 0.001). The DNI is suitable for rapid and simple estimation of the severity of traumatic injury using an automated haematologic analyser without additional cost or time.

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

“…Increased DNI at 12 hours was a strong independent predictor of shortterm mortality. In addition, the cut-off value of DNI at 12 hours to predict 30-day mortality was 5.3% in that study [18], which was similar to the result in our study. In this study, we found that although 62 (36.7%) patients had GI perforation, there was no significant difference in the mortality rate according to GI perforation (patients with GI perforation 8.1% vs. patients without GI perforation 13.1%, p = 0.319).…”

“…Previous studies about surgical and medical patients showed that DNI was a useful biomarker to predict disease severity or prognosis in patients with various infections or sepsis [7,10,16,17]. However, studies about usefulness of DNI in patients who had tissue injury or hemorrhage due to trauma are limited [18]. Systematic inflammatory response syndrome (SIRS) is initiated within 30 minutes after severe injury, which is associated with an inflammatory response to hemorrhage or tissue damage rather than infections.…”

Immature Granulocyte Count and Percentage as New Predictors of Mortality in Patients with Upper Gastrointestinal Bleeding

“… 22 A study by Kong et al . 23 conducted with trauma patients showed that IG% could be a marker of the 30-day mortality at >5.3% value. In another study, they found that severe sepsis and septic shock significantly increased in patients with an IG value > 6.5%.…”

Analysis of factors related to prognosis and death of fish bile poisoning in China: A retrospective study

“…(c) Organ failure: While few cases of organ failure are revealed in the overall circumstances, most of the deceased have developed organ failure, and a quarter of them shows the manifestation of DIC, which may cause patients to suffer from multiple organ failure (MOF) 6,22,29 . Nevertheless, compared with the general mortality of MOF patients induced by sepsis or trauma (39% to 62%), 36,37 the death rate in fish bile poisoning with MOF is relatively lower. (d) Treatment methods: It is a truism that the problem to be solved is to remove toxic substances inside the body since sufficient clearance of the toxins may improve prognosis 28 .…”