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. 2024 Jul 1;21(9):1730-1737.
doi: 10.7150/ijms.97400. eCollection 2024.

Association of Delta Neutrophil Index with the 30-day Mortality in Adult Cardiac Surgical Patients

Sujin Kim  1 , Ji-Hyoung Park  2 , Hyunjae Lim  1 , Haesung Lee  1 , Seung Woo Song  2
Affiliations

Association of Delta Neutrophil Index with the 30-day Mortality in Adult Cardiac Surgical Patients

Sujin Kim et al. Int J Med Sci. .

Abstract

Purpose: This study aimed to assess the predictive accuracy of 30-day mortality with delta neutrophil index (DNI) in adult cardiac surgical patients. Methods: This study enrolled patients who underwent cardiac surgery under general anesthesia between March 2016 and May 2022 at a tertiary hospital in the Republic of Korea. DNI was measured preoperatively, on postoperative arrival to the surgical intensive care unit (ICU), and 12, 24, 48, and 72 h postoperatively. Receiver operating characteristic (ROC) analysis was employed to identify the prediction accuracy of DNI. An area under ROC curve (AUROC) ≥0.700 was defined as satisfactory predictive accuracy. An optimal cutoff point for the DNI value to maximize predictive accuracy was revealed in the ROC curve, where [sensitivity + specificity] was maximum. Results: This study included a total of 843 patients in the final analyses. The mean age of the study population was 66.9±12.2 years and 38.4% of them were female patients. The overall 30-day mortality rate was 5.2%. Surgery involving the thoracic aorta, history of prior cardiac surgery, or emergency surgery were associated with a higher mortality rate. The DNI showed satisfactory predictive accuracy at 24 h, 48 h, and 72 h postoperatively, with AUROC of 0.729, 0.711, and 0.755, respectively. The optimal cutoff points of DNI at each time point were 3.2, 3.8, and 2.3, respectively. Conclusions: Postoperative DNI is a good predictor of 30-day mortality after cardiac surgery and has the benefit of no additional financial costs or time.

Keywords: blood cell count; cardiac surgical procedures; critical care; delta neutrophil index; perioperative care.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interest exists.

Figures

Figure 1
Figure 1
Study flow diagram.
Figure 2
Figure 2
DNI trend through a postoperative period in both groups.
Figure 3
Figure 3
A ROC curve of DNI for postoperative mortality at each time point. A, On admission to the ICU; B, 12 h postoperatively; C, 24 h postoperatively; D, 48 h postoperatively; E, 72 h postoperatively.
See this image and copyright information in PMC

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