ArticleBMC infectious diseases2011
Delta neutrophil index as an early marker of disease severity in critically ill patients with sepsis.
Article in BMC infectious diseases, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 64 papers, 2 of them syntheses that pooled it.
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Who cites it
64 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- A consensus immune dysregulation framework for sepsis and critical illnesses.Nature medicine · 2025Guideline
- Delta neutrophil index (DNI) as a novel diagnostic and prognostic marker of infection: a systematic review and meta-analysis.Inflammation research : official journal of the European Histamine Research Society ... [et al.] · 2017Pooled it
- Leukoerythroblastosis was associated with 90-day mortality in adult ICU patients with sepsis: a retrospective cohort study.BMC anesthesiology · 2026Article
- Multimarker Composite Prediction of Early Allograft Dysfunction and 90-Day Mortality After Liver Transplantation: Development and Internal Validation of the DLC Score.Journal of clinical medicine · 2026Article
- The Role of the Delta Neutrophil Index in Determining the Severity of Intrahepatic Cholestasis of Pregnancy.Saudi medical journal · 2026Article
- Delta Neutrophil Index in Suspected Septic Arthritis: A Diagnostic Accuracy Study.Journal of clinical medicine · 2026Article
- The Accuracy and Sensitivity of Delta Neutrophil Index in Malignancy: Diagnostic Study of Different Types.Diagnostics (Basel, Switzerland) · 2025Article
- Predictive value of elevated interleukin-33 levels for multi-organ dysfunction syndrome in trauma patients in South Korea: a prospective observational study.Acute and critical care · 2025Article
- A Usefulness of Delta Neutrophil Index (DNI) for Prediction of 28 Day Mortality in Patients with Pneumonia-Induced Sepsis in the Intensive Care Unit.Journal of clinical medicine · 2025Article
- Delta Neutrophil Index and Other Hematologic Parameters in Acute Exacerbations of COPD: A Retrospective Study.Canadian respiratory journal · 2025Article
- Delta Neutrophil Index in Coronary Artery Bypass Surgery: An Innovation in Postoperative Mortality Assessment.Journal of inflammation research · 2025Article
- Delta neutrophil index (DNI) as a potential biomarker for fetal growth restriction: insights from maternal hematological changes and neonatal outcomes.BMC pregnancy and childbirth · 2024Article
- The cellular composition of chronic subdural hematoma.Acta neurochirurgica · 2024Article
- Prognostic and Diagnostic Power of Delta Neutrophil Index and Mean Platelet Component in Febrile Patients with Suspected Sepsis.Biomedicines · 2023Article
- Delta Neutrophil Index as a New Marker of Purulent Inflammation in Men With Non-odontogenic Abscesses of the Neck.Cureus · 2023Article
- Delta Neutrophil Index as a New Early Mortality Predictor after Liver Transplantation.Journal of clinical medicine · 2023Article
- Performance Comparison of Procalcitonin, Delta Neutrophil Index, C-Reactive Protein, and Serum Amyloid A Levels in Patients with Hematologic Diseases.Diagnostics (Basel, Switzerland) · 2023Article
- Improved Early Detection Models of Pharyngocutaneous Fistula after Total Laryngectomy.Journal of clinical medicine · 2023Article
- Adjuvant intravenous immunoglobulin administration on postoperative critically ill patients with secondary peritonitis: a retrospective study.Acute and critical care · 2023Article
- An effective and reliable marker in gradıng the severity of acute cholecystitis: Increased immature granulocyte percentage.Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES · 2022Article
4 more citing papers are in PubMed but not listed here.
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe immature granulocyte count has been reported to be a marker of infection and sepsis. The difference in leukocyte subfractions (delta neutrophil index, DNI) in ADVIA 2120 reflects the fraction of circulating immature granulocytes in the blood. This study evaluated the clinical utility of DNI as a severity and prediction marker in critically ill patients with sepsis.
methodsOne hundred and three patients admitted to the medical intensive care unit with sepsis were studied. DNI (the difference in leukocyte subfractions identified by myeloperoxidase and nuclear lobularity channels) was determined using a specific blood cell analyzer.
resultsForty four patients (42.7%) were diagnosed with severe sepsis/septic shock. Overt disseminated intravascular coagulation (DIC) occurred in 40 (38.8%). DNI was significantly higher in patients with severe sepsis/septic shock and overt DIC than in patients without (p < 0.05). DNI correlated with DIC score (r = 0.54, p < 0.001). We observed a monotonic increase in the proportion of overt DIC and severe sepsis/septic shock associated with increasing quartiles of DNI (p < 0.001). A DNI value > 6.5% was a better indicator of severe sepsis/septic shock than C-reactive protein, lactate, white blood cell count, and absolute neutrophil count (sensitivity, 81.3%; specificity, 91.0%; positive predictive value, 88.6%; and negative predictive value, 84.7%). In 36 (82%) of the 44 patients with severe sepsis/septic shock, DNI values were already elevated up to 12 hours before the onset of organ/circulatory failure.
conclusionsDNI may be used as a marker of disease severity in critically ill patients with sepsis. High levels of DNI may help to identify patients with an impending risk of developing severe sepsis/septic shock.
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