Value of the Delta Neutrophil Index for Predicting 28-Day Mortality in Patients With Acute Pulmonary Embolism in the Emergency Department
| Autor: | Jong Wook Lee, Sinae Kim, Sung Phil Chung, Gina Yu, Hyun Soo Chung, Taeyoung Kong, Je Sung You, Hye Sun Lee, Yoo Seok Park, Incheol Park, Claire H Eun |
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| Rok vydání: | 2018 |
| Předmět: |
Male
Disease free survival medicine.medical_specialty Time Factors Neutrophils 030204 cardiovascular system & hematology Critical Care and Intensive Care Medicine Disease-Free Survival Leukocyte Count 03 medical and health sciences 0302 clinical medicine Internal medicine Humans Medicine In patient Survival rate Aged Retrospective Studies Aged 80 and over business.industry Immature Granulocyte 030208 emergency & critical care medicine Retrospective cohort study Emergency department Middle Aged medicine.disease Pulmonary embolism Survival Rate Acute Disease Emergency medicine Emergency Medicine Cardiology Female Emergency Service Hospital Pulmonary Embolism business 28 day mortality Biomarkers |
| Zdroj: | Shock. 49:649-657 |
| ISSN: | 1540-0514 1073-2322 |
| Popis: | Acute pulmonary embolism (PE), frequently seen in the emergency department (ED), is a leading cause of cardiovascular morbidity and mortality. The delta neutrophil index (DNI) reflects the fraction of circulating immature granulocytes as a component of the systemic inflammatory response syndrome criteria. The pathogenesis of acute PE is significantly associated with inflammation. The aim of the study was to investigate the clinical usefulness of the DNI as a marker of severity in patients with acute PE admitted to the ED.We retrospectively analyzed the data of patients who were diagnosed with acute PE at a single ED, admitted from January 1, 2011 to June 30, 2017. The diagnosis of acute pulmonary embolism was confirmed using clinical, laboratory, and radiological findings. The DNI was determined at presentation. The clinical outcome was all-cause mortality within 28 days of emergency department admission.We included 447 patients in this study. The multivariate Cox regression model demonstrated that higher DNI values on ED admission were significantly associated with short-term mortality (hazard ratio, 1.107; 95% confidence interval, 1.042-1.177). The optimal cut-off DNI value, measured on ED admission, was 3.0%; this value was associated with an increased hazard of 28-day mortality following PE (HR, 7.447; 95% CI, 4.183-13.366; P 0.001) CONCLUSION:: The DNI value, obtained as part of the complete blood count analysis, can be easily determined without additional burdens of cost or time. A high DNI is useful as a marker to predict 28-day mortality in patients with acute PE. |
| Databáze: | OpenAIRE |
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