Usefulness of the Delta Neutrophil Index as a Promising Prognostic Marker of Acute Cholangitis in Emergency Departments

Abstract

Higher DNI levels are predictive markers of hemodynamic instability and 28-day mortality in patients with acute cholangitis. The accuracy of DNI for predicting hemodynamic instability and 28-day mortality is superior to that of other parameters.

Usefulness of the delta neutrophil index to predict 30-day mortality in patients with ST segment elevation myocardial infarction

“…The immature granulocyte is a practical marker of local and systemic inflammation 10 – 12 . The use of a specific automated blood cell analyser—a recent technological advancement—allows rapid determination of the delta neutrophil index (DNI), which reflects the fraction of circulating immature granulocytes in the blood, along with the complete blood count (CBC) 10 , 11 , 13 – 15 . Herein, we evaluated the significance of the DNI as a prognostic marker of early mortality in patients with STEMI who underwent pPCI.…”

Delta Neutrophil Index for the Prediction of Prognosis in Acute Gastrointestinal Diseases; Diagnostic Test Accuracy Meta-Analysis

“…60 studies were finally excluded according to the exclusion criteria: not relevant to GI diseases (n = 42), pediatric study (n = 11), abstract only study (n = 2), animal study (n = 2), study protocol (n = 1), and systematic review or meta-analysis (n = 2). The remaining 12 articles [9,[17][18][19][20][21][22][23][24][25][26][27] were included in the systematic review. Among the 12 studies, Kim JW et al [22] explored the prognostic role of DNI measured at admission day 3, and the results of the study by Cha YS et al [26] cannot be extrapolated as a form of TP, FP, FN, or TN (although we contacted corresponding author, we could not get the crude numbers of TP, FP, FN, or TN).…”

“…Among the 12 studies, Kim JW et al [22] explored the prognostic role of DNI measured at admission day 3, and the results of the study by Cha YS et al [26] cannot be extrapolated as a form of TP, FP, FN, or TN (although we contacted corresponding author, we could not get the crude numbers of TP, FP, FN, or TN). Therefore, these two publications were excluded in the quantitative analysis, and a total of 10 studies [9,[17][18][19][20][21][23][24][25]27] were included in the meta-analysis of diagnostic test accuracy. Figure 1 presents a flow diagram showing the process for identifying the relevant studies.…”

“…From the 10 studies [9,[17][18][19][20][21][23][24][25]27] for the prediction of prognosis in GI diseases, a total of 2766 patients (518 patients with GI diseases vs. 2248 controls) were identified. Among all, eight studies [9,[17][18][19][20][21]23,27] were conducted in a case-control format, whereas two studies [24,25] were conducted in a cohort format. All the studies were conducted in Korea, and the median age of the population enrolled in the studies ranged from 35 to 70 years.…”

The Emergency Medicine−Focused Review of Cholangitis

“…A recent mortality prediction risk model suggests that grade II disease can be surgically decompressed within 24 h without worsening outcomes (24). On the horizon is the use of delta neutrophil index, which quantifies the fraction of circulating immature granulocytes and has shown promise in identifying patients at increased risk of 28-day mortality as a result of severe cholangitis (44).…”