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Sci Rep. 2018 Apr 26;8(1):6621. doi: 10.1038/s41598-018-24211-7.

The delta neutrophil index (DNI) as a prognostic marker for mortality in adults with sepsis: a systematic review and meta-analysis.

Author information

1
Department of Emergency Medicine, Armed Forces Yangju Hospital, Yangju, Korea.
2
Department of Biomedical Engineering, Graduate School of Medicine, Hanyang University, Seoul, Korea.
3
Department of Emergency Medicine, College of Medicine, Hallym University, Chuncheon, Korea.
4
Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul, Korea. erthim@gmail.com.
5
Department of Neurosurgery, College of Medicine, Hanyang University, Seoul, Korea.
6
Department of Preventive Medicine, College of Korean Medicine, Kyung Hee University, Seoul, Korea.

Abstract

We performed a meta-analysis to seek evidence for the usefulness of the delta neutrophil index (DNI) as a prognostic blood biomarker for mortality in the early stage of sepsis in adults. A literature search was performed using criteria set forth in a predefined protocol. Studies of adults with sepsis that provided a DNI measurement and that had mortality as the outcome, were included. Review articles, editorials, and non-human studies were excluded. The methodological quality of identified studies was assessed independently by two authors using the Quality in Prognosis Studies (QUIPS) tool. A total of 1,822 patients from eleven studies were ultimately included. Standardized mean differences between non-survivors and survivors were compared. An elevated DNI was associated with mortality in patients with sepsis (standardized mean difference [SMD] 1.22; 95% confidence interval 0.73-1.71; I2 = 91%). After excluding two studies-one that included paediatric patients and one with a disproportionately low mortality rate-heterogeneity was minimized (SMD 0.74, 95% confidence interval 0.53-0.94; I2 = 43%). Overall, the findings suggest that high DNI values are associated with mortality in septic patients.

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