J Korean Burn Soc.  2019 Dec;22(2):38-44. 10.0000/jkbs.2019.22.2.38.

Delta Neutrophil Index as an Early Marker of Sepsis in Burn Patients

• Kim CM
• Ha CM

• KMID: 2469247
• DOI: http://doi.org/10.0000/jkbs.2019.22.2.38

Abstract

PURPOSE
The immature granulocyte count has been reported to be a marker of infection and sepsis. The difference in leukocyte subfractions (delta neutrophil index, DNI) in ADVIA 2120 reflects the fraction of circulating immature granulocytes in the blood. This study evaluated the clinical utility of DNI as a severity and prediction marker in critically ill patients with burn sepsis.
METHODS
One hundred and sixty nine patients admitted to the burn care unit were studied. DNI (the difference in leukocyte subfractions identified by myeloperoxidase and nuclear lobularity channels) was determined using a specific blood cell analyzer.
RESULTS
Seventy one patients (42 %) were diagnosed with burn sepsis. DNI was significantly higher in patients with burn sepsis than in patients without (P < 0.01). Delta neutrophil index was a better indicator of burn sepsis than C-reactive protein, lactate, white blood cell count, HCO3, base excess, lactate, procalcitonin (odds ratio, 6.31; confidence interval 2.36~16.90; P < 0.01). And the receiver operating characteristic curves showed that delta neutrophil index, AUC 0.795 (95% confidence interval, 0.721~0.869; P < 0.05) was a better predictor of burn sepsis than lactate, procalcitonin, white blood cell, base excess and abbreviated burn severity index.
CONCLUSION
Delta neutrophil index may be used as a early marker of patients with burn sepsis.

Keyword

Burns; Sepsis; Biomarkers

MeSH Terms

Area Under Curve
Biomarkers
Blood Cells
Burns*
C-Reactive Protein
Critical Illness
Granulocytes
Humans
Lactic Acid
Leukocyte Count
Leukocytes
Neutrophils*
Peroxidase
ROC Curve
Sepsis*
Biomarkers
C-Reactive Protein
Lactic Acid
Peroxidase