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J Korean Soc Emerg Med > Volume 31(2); 2020 > Article
Journal of The Korean Society of Emergency Medicine 2020;31(2): 152-160.
Delta neutrophil index가 응급센터를 통하여 중환자실로 입원한 환자들의 원내 사망률을 예측할 수 있는가?
윤영탁 , 김영식 , 하영록 , 신태용 , 정루비 , 이규현 , 유우성 , 김동훈
분당제생병원 응급의학과
Does delta neutrophil index predict 30-day mortality in patients admitted to intensive care unit via emergency department?
Young Tak Yoon , Young Sik Kim , Young Rock Ha , Tae Yong Shin , Ru Bi Jung , Kyoo-Hyun Lee , Woo Sung Yu , Donghoon Kim
Department of Emergency Medicine, Daejin Medical Center, Bundang Jesaeng General Hospital, Seongnam, Korea
Correspondence  Young Tak Yoon ,Tel: 031-779-0183, Fax: 031-779-6528, Email: leafflag@naver.com,
Received: July 31, 2019; Revised: September 3, 2019   Accepted: September 9, 2019.  Published online: April 30, 2020.
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.
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.
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).
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.
Key words: Delta neutrophil index; Mortality rate; Emergency department; Intensive care unit
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