Acute and Critical Care

Original Articles

Hematology/Pediatric
Delta Neutrophil Index as a Prognostic Marker in the Pediatric Intensive Care Unit: In Suk Sol, Hyun Bin Park, Min Jung Kim, Seo Hee Yoon, Yoon Hee Kim, Kyung Won Kim, Myung Hyun Sohn, Kyu-Earn Kim; Korean J Crit Care Med. 2016;31(4):351-358. Published online November 30, 2016; DOI: https://doi.org/10.4266/kjccm.2016.00171

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Background
The delta neutrophil index (DNI) is a useful marker for diagnosing and predicting the prognosis of sepsis. The purpose of this study was to investigate the usefulness of DNI as a prognostic marker in patients within the pediatric intensive care unit (PICU), as well as its association with other prognostic factors.
Methods
A total of 516 children admitted to Severance Children’s Hospital PICU from December 2009 to February 2015 were analyzed. DNI was measured on the day of PICU admission. Mortality was defined as death within 28 days following PICU admission.
Results
The median value of DNI was 1.2% (interquartile range [IQR] 0-4.3%) in the survivor group and 9.5% (IQR 2.3-20.8%) in the non-survivor group, and the difference was statistically significant (p < 0.001). DNI was significantly positively correlated with ICU scores such as Pediatric Index of Mortality 3 and Pediatric Risk of Mortality III, as well as with C-reactive protein and lactate levels. The area under the receiver operating characteristic curve of DNI for mortality was 0.748 (95% CI: 0.687-0.808) and the cut-off value was 4.95%.
Conclusions
The initial DNI level can be considered a useful indicator for predicting prognosis in PICU patients.

Citations

Citations to this article as recorded by

Performance Comparison of Procalcitonin, Delta Neutrophil Index, C-Reactive Protein, and Serum Amyloid A Levels in Patients with Hematologic Diseases
Jooyoung Cho, Jong-Han Lee, Dong Hyun Lee, Juwon Kim, Young Uh
Diagnostics.2023; 13(7): 1213. CrossRef
Potential and promising marker for serious bacterial infections in children: Delta neutrophil index
Metin Yigit, Aslinur Ozkaya‐Parlakay, Naci Yilmaz, Ozhan Akyol, Belgin Gulhan, Saliha Kanik Yuksek, Basak Yalcin Burhan, Enes K Kilic, Cuneyt Karagol
Journal of Paediatrics and Child Health.2022; 58(9): 1623. CrossRef
Delta Neutrophil Index as a Diagnostic Marker of Neonatal Sepsis
Nuriye Asli Melekoglu, Seyma Yasar, Mehmet Keskin
Journal of Pediatric Infectious Diseases.2021; 16(03): 099. CrossRef
Prognostic value of the delta neutrophil index in pediatric cardiac arrest
Seo Hee Yoon, Eun Ju Lee, Jinae Lee, Moon Kyu Kim, Jong Gyun Ahn
Scientific Reports.2020;[Epub] CrossRef

Usefulness of Thrombocytopenia and Changes in Platelet Counts as Prognostic Markers in Pediatric Intensive Care Units: Yoon Hee Kim, Hyun Bin Park, Min Jung Kim, Hwan Soo Kim, Hee Seon Lee, Yoon Ki Han, Kyung Won Kim, Myung Hyun Sohn, Kyu Earn Kim; Korean J Crit Care Med. 2013;28(2):93-100.; DOI: https://doi.org/10.4266/kjccm.2013.28.2.93

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Abstract PDF: BACKGROUND
Thrombocytopenia has been shown to be a useful predictor of mortality in adult intensive care units (ICUs). The aim of this study is to assess whether the level of platelet count at ICU admission and the changes in platelet counts can predict mortality in the pediatric ICU (PICU).
METHODS
Platelet counts were checked daily for at least 4 days in a total of 303 children who were admitted to the ICU. We compared the initial platelet counts and changes in platelet counts between survivors and non-survivors. A multivariable logistic regression model, a receiver operating characteristic curve and a linear mixed model were used.
RESULTS
The initial platelet count was significantly lower in non-survivors when compared to survivors. Multivariate analysis demonstrated that platelet count <120 x 10(9)/L (Odds ratio, 4.913; 95% confidence interval 2.451-9.851; p < 0.0001) was an independent predictor of mortality. In the case of children with thrombocytopenia (<120 x 10(9)/L) at admission to the ICU, the platelet counts increased serially in survivors, whereas non-survivors maintained their decreased platelet counts. In the case of children without thrombocytopenia, the platelet counts decreased most on day 3 in non-survivors.
CONCLUSIONS
At admission to the ICU, thrombocytopenia defined as a platelet count <120 x 10(9)/L can be a useful predictor of mortality in children. In children who had initial thrombocytopenia, the serial increase of platelet counts can be related to increased survival, whereas in children who did not have initial thrombocytopenia, more than a 10% decrease of platelet counts on day 3 can be related to mortality.

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