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. 2023 Nov 30;11(12):3190.
doi: 10.3390/biomedicines11123190.

Prognostic and Diagnostic Power of Delta Neutrophil Index and Mean Platelet Component in Febrile Patients with Suspected Sepsis

Taehun Lee  1 , Jongwook Lee  2 , Dong Hoon Shin  3 , Hyungdon Lee  4 , Soo-Ki Kim  5
Affiliations

Prognostic and Diagnostic Power of Delta Neutrophil Index and Mean Platelet Component in Febrile Patients with Suspected Sepsis

Taehun Lee et al. Biomedicines. .

Abstract

Background: The delta neutrophil index (DNI), a prognostic and diagnostic marker for sepsis, is based on the leukocyte count. Platelet activation, similar to leukocyte activation, plays a crucial role in host defense against pathogens and may serve as a predictor of sepsis outcome. However, the combined evaluation of mean platelet component (MPC) and DNI has rarely been used to assess sepsis.

Methods: To assess the prognostic and diagnostic validity of the simultaneous evaluation of DNI and MPC in cases of human febrile sepsis, we conducted measurements of cellular indices, including DNI and MPC, as well as molecular biomarkers, including procalcitonin (PCT) and C-reactive protein (CRP). This study was carried out in patients admitted to the emergency department with suspected sepsis.

Results: Using a cutoff value of 2.65%, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the DNI in sepsis were found to be 69%, 73.9%, 77.9%, and 64.1%, respectively. Furthermore, significant differences in DNI and MPC levels were observed between the sepsis and non-sepsis groups (6.7 ± 7.8% versus 2.1 ± 2.2% (p = 0.000) and 26.0 ± 1.9 g/dL versus 26.8 ± 1.4 g/dL (p = 0.002), respectively). Notably, there was a negative correlation between DNI and MPC, with the strength of the correlation varying based on the cause of sepsis. By setting the cutoff value of the DNI to 6.2%, its sensitivity, specificity, and NPV improved to 100%, 80.3%, and 100%, respectively, although the PPV remained at 10.6%.

Conclusions: In our study, the DNI demonstrates superior effectiveness compared with other molecular biomarkers, such as CRP and procalcitonin, in distinguishing septic febrile patients from non-septic febrile patients. Additionally, a negative correlation exists between MPC and DNI, making MPC a valuable marker for differentiating the etiology of sepsis. These findings hold significant clinical implications, as DNI/MPC evaluation is a cost-effective and readily applicable approach in various impending sepsis scenarios. Notably, this study represents the first examination of the prognostic and diagnostic validity of employing the simultaneous evaluation of DNI and MPC in human cases of febrile sepsis.

Keywords: CRP; delta neutrophil index; emergency department; fever; mean platelet component; procalcitonin; sepsis.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
ROC curves of DNI, CRP, and procalcitonin in relation to sepsis.
See this image and copyright information in PMC

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References

    1. Mackowiak P.A., Chervenak F.A., Grunebaum A. Defining Fever. Open Forum Infect. Dis. 2021;8:ofab161. doi: 10.1093/ofid/ofab161. - DOI - PMC - PubMed
    1. Bossink A.W., Groeneveld A.B., Hack C.E., Thijs L.G. The clinical host response to microbial infection in medical patients with fever. Chest. 1999;116:380–390. doi: 10.1378/chest.116.2.380. - DOI - PubMed
    1. Wrotek S., Sobocinska J., Kozlowski H.M., Pawlikowska M., Jedrzejewski T., Dzialuk A. New Insights into the Role of Glutathione in the Mechanism of Fever. Int. J. Mol. Sci. 2020;21:1393. doi: 10.3390/ijms21041393. - DOI - PMC - PubMed
    1. Scott H.F., Deakyne S.J., Woods J.M., Bajaj L. The prevalence and diagnostic utility of systemic inflammatory response syndrome vital signs in a pediatric emergency department. Acad. Emerg. Med. 2015;22:381–389. doi: 10.1111/acem.12610. - DOI - PubMed
    1. Berardinelli F., De Francesco P., Marchioni M., Cera N., Proietti S., Hennessey D., Dalpiaz O., Cracco C., Scoffone C., Schips L., et al. Infective complications after retrograde intrarenal surgery: A new standardized classification system. Int. Urol. Nephrol. 2016;48:1757–1762. doi: 10.1007/s11255-016-1373-1. - DOI - PubMed