TY - JOUR
T1 - Use of the delta neutrophil Index as a prognostic factor of mortality in patients with spontaneous bacterial peritonitis
T2 - Implications of a simple and useful marker
AU - Lim, Tae Seop
AU - Kim, Beom Kyung
AU - Lee, Jong Wook
AU - Lee, Young Ki
AU - Chang, Sooyun
AU - Kim, Seung Up
AU - Kim, Do Young
AU - Ahn, Sang Hoon
AU - Han, Kwang Hyub
AU - Chon, Chae Yoon
AU - Park, Jun Yong
PY - 2014/1/23
Y1 - 2014/1/23
N2 - Background: Spontaneous bacterial peritonitis (SBP) is a common and life-threatening infection in patients with advanced cirrhosis. The prognostic value of a novel marker, the delta neutrophil index (DNI), was investigated relative to mortality in patients with SBP. Materials & Methods: Seventy-five patients with SBP were studied from April 2010 to May 2012. DNI at initial diagnosis of SBP was determined and compared with 30-day mortality rates. Results: Of the patients, 87.7% were men, and the median age of all patients was 59.0 yrs. The area under the receiveroperating characteristic (ROC) curve of DNI for 30-day mortality was 0.701 (95% confidence interval [CI], 0.553-0.849; p = 0.009), which was higher than that of C-reactive protein (0.640, 95% CI, 0.494-0.786; p = 0.076) or the model for endstage liver disease score (0.592, 95% CI, 0.436-0.748; p = 0.235). From the ROC curve, with the sum of sensitivity and specificity, the cutoff value of DNI was determined to be 5.7%. In the high-DNI group (DNI ≥5.7%), septic shock and 30-day mortality were more prevalent compared with the low-DNI group (84.2% vs. 48.2%, p = 0.007; 57.9% vs. 14.3%, p<0.001, respectively). Patients with an elevated DNI had a higher risk of 30-day mortality compared with those with a low DNI (4.225, 95% CI, 1.631-10.949; p = 0.003). Conclusion: A higher DNI at the time of SBP diagnosis is an independent predictor of 30-day mortality in patients with SBP.
AB - Background: Spontaneous bacterial peritonitis (SBP) is a common and life-threatening infection in patients with advanced cirrhosis. The prognostic value of a novel marker, the delta neutrophil index (DNI), was investigated relative to mortality in patients with SBP. Materials & Methods: Seventy-five patients with SBP were studied from April 2010 to May 2012. DNI at initial diagnosis of SBP was determined and compared with 30-day mortality rates. Results: Of the patients, 87.7% were men, and the median age of all patients was 59.0 yrs. The area under the receiveroperating characteristic (ROC) curve of DNI for 30-day mortality was 0.701 (95% confidence interval [CI], 0.553-0.849; p = 0.009), which was higher than that of C-reactive protein (0.640, 95% CI, 0.494-0.786; p = 0.076) or the model for endstage liver disease score (0.592, 95% CI, 0.436-0.748; p = 0.235). From the ROC curve, with the sum of sensitivity and specificity, the cutoff value of DNI was determined to be 5.7%. In the high-DNI group (DNI ≥5.7%), septic shock and 30-day mortality were more prevalent compared with the low-DNI group (84.2% vs. 48.2%, p = 0.007; 57.9% vs. 14.3%, p<0.001, respectively). Patients with an elevated DNI had a higher risk of 30-day mortality compared with those with a low DNI (4.225, 95% CI, 1.631-10.949; p = 0.003). Conclusion: A higher DNI at the time of SBP diagnosis is an independent predictor of 30-day mortality in patients with SBP.
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U2 - 10.1371/journal.pone.0086884
DO - 10.1371/journal.pone.0086884
M3 - Article
C2 - 24466280
AN - SCOPUS:84899853106
SN - 1932-6203
VL - 9
JO - PloS one
JF - PloS one
IS - 1
M1 - e86884
ER -