J Korean Soc Emerg Med.  2020 Apr;31(2):152-160.

Does delta neutrophil index predict 30-day mortality in patients admitted tointensive care unit via emergency department?

• Yoon YT
• Kim YS
• Ha YR
• Shin TY
• Jung RB
• Lee KH
• Yu WS
• Kim D

Abstract

Objective
A retrospective study was performed to evaluate the usefulness of the delta neutrophil index as a prognostic factor for mortality in intensive care unit patients admitted via the emergency department.
Methods
Patients, who presented to the emergency department and were admitted to the intensive care unit from January 2018 to August 2018, were reviewed retrospectively. The clinical features, inflammatory marker levels, such as C-reactive protein, lactate, simplified acute physiology score 3, length of stay, and in-hospital mortality were obtained from the medical records. Patients, who visited the emergency department because of trauma or suicidal attempts, arrived after out-hospital cardiac arrest, or were diagnosed with cerebrovascular disease, were excluded.
Results
Of the 310 patients included, 65 died during their admission, and 245 patients were discharged after treatment. The receiver operating characteristic curve showed that the delta neutrophil index (area under curve [AUC], 0.72), Creactive protein (AUC, 0.70), lactate (AUC, 0.64), and simplified acute physiology score 3 (AUC, 0.79) indicated a low predictive power for in-hospital mortality. Whole patients were divided into four subgroups (infectious diseases, cardiovascular diseases, gastrointestinal bleeding diseases, and others). The receiver operating curve of delta neutrophil index revealed infectious diseases (AUC, 0.65), in cardiovascular diseases (AUC, 0.70), and gastrointestinal bleeding diseases (AUC, 0.79).
Conclusion
The role of the delta neutrophil index for predicting the prognosis of in-hospital mortality showed equally low predictive power for critically ill patients with the C-reactive protein and lactate.

Keyword

Delta neutrophil index; Mortality rate; Emergency department; Intensive care unit