Yoon Jung Hwang1, Sung Phil Chung1, Yoo Seok Park1, Hyun Soo Chung1, Hye Sun Lee2, Jong Woo Park3, Jong Wook Lee4, Jung Hwa Hong2, Je Sung You5, Incheol Park1. 1. Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea. 2. Department of Research Affairs, Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Republic of Korea. 3. Department of Emergency Medicine, Changwon Fatima Hospital, Changwon, Republic of Korea. 4. Department of Laboratory Medicine, Jincheon Sungmo Hospital, Jincheon, Republic of Korea; Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, Korea. 5. Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Department of Emergency Medicine, Graduate School of Medicine, Kangwon National University, Chuncheon, Republic of Korea. Electronic address: youjsmd@yuhs.ac.
Abstract
PURPOSE: We evaluated the ratio of delta neutrophil index (DNI) to albumin (A) in patients receiving early goal-directed therapy (EGDT) to determine the prognostic significance of the DNI/A ratio as a marker of early mortality in critically ill patients with suspected sepsis. METHODS: We retrospectively analyzed records from a prospective EGDT registry in an emergency department (ED) and screened eligible adult patients who were admitted to the ED with severe sepsis and/or septic shock. The new DNI/A ratio was calculated as the DNI value on each hospital day divided by the initial albumin level on ED admission. The clinical outcome was mortality after 28 days. RESULTS: A total of 120 patients receiving EGDT were included in this study. Multivariate Cox proportional-hazard models revealed that higher DNI/A ratios on day 1 (hazard ratio [HR], 1.068; 95% confidence interval [CI], 1.01-1.13; P = .0209) and the peak day (HR, 1.057; 95% CI, 1.001-1.116; P = .0456) were independent risk factors for mortality at 28 days. Our study demonstrated that the increased trend toward 28-day mortality was associated with a DNI/A ratio greater than 8.4 on day 1 (HR, 2.513; 95% CI, 0.950-6.64; P = .0528) and a higher DNI/A ratio (>6.4) on the peak day (average, 4.2 days; HR, 2.953; 95% CI, 1.033-8.441; P < .001) in patients with severe sepsis receiving EGDT. CONCLUSION: The ratio of DNI to serum albumin on ED admission is a promising prognostic marker of 28-day mortality in patients with severe sepsis receiving EGDT.
PURPOSE: We evaluated the ratio of delta neutrophil index (DNI) to albumin (A) in patients receiving early goal-directed therapy (EGDT) to determine the prognostic significance of the DNI/A ratio as a marker of early mortality in critically illpatients with suspected sepsis. METHODS: We retrospectively analyzed records from a prospective EGDT registry in an emergency department (ED) and screened eligible adult patients who were admitted to the ED with severe sepsis and/or septic shock. The new DNI/A ratio was calculated as the DNI value on each hospital day divided by the initial albumin level on ED admission. The clinical outcome was mortality after 28 days. RESULTS: A total of 120 patients receiving EGDT were included in this study. Multivariate Cox proportional-hazard models revealed that higher DNI/A ratios on day 1 (hazard ratio [HR], 1.068; 95% confidence interval [CI], 1.01-1.13; P = .0209) and the peak day (HR, 1.057; 95% CI, 1.001-1.116; P = .0456) were independent risk factors for mortality at 28 days. Our study demonstrated that the increased trend toward 28-day mortality was associated with a DNI/A ratio greater than 8.4 on day 1 (HR, 2.513; 95% CI, 0.950-6.64; P = .0528) and a higher DNI/A ratio (>6.4) on the peak day (average, 4.2 days; HR, 2.953; 95% CI, 1.033-8.441; P < .001) in patients with severe sepsis receiving EGDT. CONCLUSION: The ratio of DNI to serum albumin on ED admission is a promising prognostic marker of 28-day mortality in patients with severe sepsis receiving EGDT.
Authors: A Pyrpasopoulou; P Pateinakis; A Varouktsi; E Georgianou; I Zografou; E Roilides; A Karagiannis Journal: Hippokratia Date: 2016 Oct-Dec Impact factor: 0.471
Authors: Jae Hyon Park; Hyeong Ju Byeon; Keum Hwa Lee; Jong Wook Lee; Andreas Kronbichler; Michael Eisenhut; Jae Il Shin Journal: Inflamm Res Date: 2017-06-23 Impact factor: 4.575
Authors: Dong Ryul Ko; Taeyoung Kong; Hye Sun Lee; Sinae Kim; Jong Wook Lee; Hyun Soo Chung; Sung Phil Chung; Je Sung You; Jong Woo Park Journal: J Clin Med Date: 2019-06-06 Impact factor: 4.241