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Meta-Analysis
. 2018 Apr 26;8(1):6621.
doi: 10.1038/s41598-018-24211-7.

The delta neutrophil index (DNI) as a prognostic marker for mortality in adults with sepsis: a systematic review and meta-analysis

Chiwon Ahn  1   2 , Wonhee Kim  2   3 , Tae Ho Lim  4 , Youngsuk Cho  2   3 , Kyu-Sun Choi  5 , Bo-Hyoung Jang  6
Affiliations
Meta-Analysis

The delta neutrophil index (DNI) as a prognostic marker for mortality in adults with sepsis: a systematic review and meta-analysis

Chiwon Ahn et al. Sci Rep. .

Abstract

We performed a meta-analysis to seek evidence for the usefulness of the delta neutrophil index (DNI) as a prognostic blood biomarker for mortality in the early stage of sepsis in adults. A literature search was performed using criteria set forth in a predefined protocol. Studies of adults with sepsis that provided a DNI measurement and that had mortality as the outcome, were included. Review articles, editorials, and non-human studies were excluded. The methodological quality of identified studies was assessed independently by two authors using the Quality in Prognosis Studies (QUIPS) tool. A total of 1,822 patients from eleven studies were ultimately included. Standardized mean differences between non-survivors and survivors were compared. An elevated DNI was associated with mortality in patients with sepsis (standardized mean difference [SMD] 1.22; 95% confidence interval 0.73-1.71; I2 = 91%). After excluding two studies-one that included paediatric patients and one with a disproportionately low mortality rate-heterogeneity was minimized (SMD 0.74, 95% confidence interval 0.53-0.94; I2 = 43%). Overall, the findings suggest that high DNI values are associated with mortality in septic patients.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Flow chart of the study selection process.
Figure 2
Figure 2
Meta-analysis for relevant studies. Mean delta neutrophil index value between non-survivors and survivors.
Figure 3
Figure 3
Sensitivity analysis; Forest plot of seven studies after removing the studies by Zanaty et al. and Kim et al..
Figure 4
Figure 4
Summary receiver operating characteristic (SROC) curve of delta neutrophil index (DNI) for predicting mortality.
See this image and copyright information in PMC

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