Which patients with intestinal obstruction need surgery? The delta neutrophil index as an early predictive marker
Annals of Surgical Treatment and Research
;
: 272-276, 2017.
Artículo
en Inglés
| WPRIM
| ID: wpr-224354
ABSTRACT
PURPOSE:
Predicting the need for surgical intervention among patients with intestinal obstruction is challenging. The delta neutrophil index (DNI) has been suggested as a useful marker of immature granulocytes, which indicate an infection or sepsis. In this study, we evaluated the impact of the DNI as an early predictor of operation among patients with intestinal obstruction.METHODS:
A total of 171 patients who were diagnosed with postoperative intestinal obstruction were enrolled in this study. Medical records, including data for the initial CRP level, WBC count, and DNI were reviewed. Receiver operating characteristic (ROC) curves were generated to clarify the optimal DNI cutoff values for predicting an operation.RESULTS:
Among the 171 patients, 38 (22.2%) needed surgical intervention. The areas under the initial CRP, WBC, and DNI ROC curves were 0.460, 0.449, and 0.543, respectively. The optimal cutoff value for predicting further surgical intervention according to the initial DNI level was 4.3%. The accuracy of the cutoff value was 74.9%, the sensitivity was 23.7%, and the specificity was 89.5% (positive predictive value, 23.7%; negative predictive value, 89.5%). In the multivariate analysis, initial DNI levels ≥ 4.3% were significantly associated with surgical intervention (odd ratio, 3.092; 95% confidence interval, 1.072–8.918; P = 0.037).CONCLUSION:
The initial DNI level in patients with intestinal obstruction may be a useful predictor for determining the need for surgical intervention.
Texto completo:
Disponible
Índice:
WPRIM (Pacífico Occidental)
Asunto principal:
Registros Médicos
/
Análisis Multivariante
/
Curva ROC
/
Sensibilidad y Especificidad
/
Sepsis
/
Granulocitos
/
Obstrucción Intestinal
/
Neutrófilos
Tipo de estudio:
Estudio diagnóstico
/
Estudio pronóstico
Límite:
Humanos
Idioma:
Inglés
Revista:
Annals of Surgical Treatment and Research
Año:
2017
Tipo del documento:
Artículo
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