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- 저자 : ( Jonghyun Jhee ) (검색결과 1 건)
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Delta Neutrophil Index is a Predictor of Disease Severity in Patients with Acute Pyelonephritis
( Geun Woo Ryu ),( Hyung Woo Kim ),( Seohyun Park ),( Sul A Lee ),( Jonghyun Jhee ),( Su-young Jung ),( Hyung Jung Oh ),( Jung Tak Park ),( Seung Hyeok Han ),( Shin-wook Kang ),( Tae-hyun Yoo ) 대한내과학회 2015 대한내과학회 추계학술대회 Vol.2015 No.1
Background: Delta neutrophil index (DNI) is the fraction of immature granulocytes provided by a complete blood count analyzer. Previous studies demonstrated that DNI is a novel marker to predict outcomes in sepsis patients. Therefore, this study aimed to evaluate DNI as a predictor of disease severity in patients with acute pyelonephritis (APN). Methods: Patients diagnosed with APN at Severance Hospital from December 2009 to July 2012 were retrospectively investigated. DNI levels were measured at the time of admission. The patients were classified into two groups according to the median value of DNI at baseline. Severe APN was diagnosed with one or more of these conditions including bacteremia, acute kidney injury, hypotension requiring use of vasopressors and admission of intensive care unit. Independent risk factors for severe APN were determined by multiple logistic regression analysis. Receiver operating characteristic (ROC) curves were plotted for DNI, white blood cell (WBC) count and C-reactive protein (CRP). Results: A total of 258 patients were included in this study. The median age was 61.0 (19.0-87.0), 237 patients (91.9%) were female, and the median DNI level was 2.5%. Severe APN was significantly more prevalent in high DNI group. Multivariate analysis showed that DNI, WBC count and CRP level independently predicted severe APN. DNIwas a better predictive marker of severe APN than WBC count, as reflectd by area under the ROC curve analysis (0.697 [95% CI, 0.637-0.753] vs. 0.562 [95% CI, 0.499-0.624], p=0.0013). DNI was not inferior to CRP levels to predict severe APN (0.697 [95% CI, 0.637-0.753] vs. 0.633 [95% CI, 0.571-0.692], p=0.1185). Conclusions: DNI level at admission is a valuable predictor of disease severity in patients with APN.
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