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. 2021 Dec 23;100(51):e28311.
doi: 10.1097/MD.0000000000028311.

Usefulness of delta neutrophil index as a biomarker to predict postoperative complication in patients who underwent esophagectomy: A case-control study

Seong Chan Gong  1 , Hoon Ryu  1 , Ji Young Jang  2
Affiliations

Usefulness of delta neutrophil index as a biomarker to predict postoperative complication in patients who underwent esophagectomy: A case-control study

Seong Chan Gong et al. Medicine (Baltimore). .

Abstract

Esophagectomy demonstrates a high incidence of complications owing to its complexity and invasiveness; hence, early detection of complications is important. We aimed to evaluate the predictive value of the delta neutrophil index (DNI) for complications after esophagectomy.We retrospectively analyzed patients who underwent esophagectomy in the department of general surgery at a single institution between January 2011 and October 2020. Patient characteristics, laboratory findings, and clinical outcomes were assessed.Fifty-seven patients were enrolled in this study, of whom 31 (54.4%) had complications. The complication group had significantly longer mean mechanical ventilation, hospital stay and intensive care unit stay periods, and higher acute physiology, age, chronic health evaluation score and mortality rate than the noncomplication group. DNI on postoperative day (POD) 2 was also significantly higher in the complication group. Logistic regression analysis showed that DNI on POD 2 was an independent risk factor associated with the complications. Receiver operating characteristic curve analysis showed that the area under curve of DNI on POD 2 was 0.712 (cutoff value: 2.15%, sensitivity 61.5%, and specificity 70.8%).Our study indicated that postoperative DNI can be useful as an early predictive biomarker of the complications after esophagectomy.

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Conflict of interest statement

The authors have no funding and conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Order of investigations.
Figure 2
Figure 2
Receiver operating characteristic (ROC) curve analysis for delta neutrophil index (DNI) on postoperative day 2. Postoperative day 2 DNI: area under curve (AUC), 0.712 (95% CI: 0.567–0.856); cutoff DNI score, 2.15%; sensitivity, 61.5%; specificity, 70.8%; P = .01.
Figure 3
Figure 3
Receiver operating characteristic (ROC) curve analysis for delta neutrophil index (DNI) on postoperative day 2 combined with white blood cell (WBC) on postoperative day 3. Postoperative day 2 DNI with postoperative day 3 WBC: area under the curve (AUC), 0.763 (95% CI: 0.634–0.892); cutoff DNI score, 2.15%; cutoff WBC count, 8515 cells/μL; sensitivity, 75.9%; specificity, 73.1%; P < .01.
Figure 4
Figure 4
Changes in postoperative serial labs. (A) White blood cell (WBC) count during the postoperative period. (B) Neutrophil count during the postoperative period. (C) Delta neutrophil index (DNI) during the postoperative period. The mean DNI value of the complication group was significantly higher than that of the noncomplication group on postoperative day 2. (D) C-reactive protein (CRP) during the postoperative period.
See this image and copyright information in PMC

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