Delta neutrophil index as an early predictor of acute appendicitis and acute complicated appendicitis in adults

Abstract Background This retrospective study aimed to evaluate the ability of the delta neutrophil index (DNI) to predict histologically normal appendicitis preoperatively and to differentiate between simple and complicated appendicitis. Methods The data from 650 patients were divided into positive...

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Main Authors: Dong Hyuk Shin, Young Suk Cho, Gyu Chong Cho, Hee Cheol Ahn, Seung Min Park, Seung Wook Lim, Young Taeck Oh, Ji Woong Cho, Sang O. Park, Young Hwan Lee
Format: Article
Language:English
Published: BMC 2017-07-01
Series:World Journal of Emergency Surgery
Subjects:
Online Access:http://link.springer.com/article/10.1186/s13017-017-0140-7
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spelling doaj-a40fccbb9f134684ad38dc734f92d67b2020-11-25T01:41:48ZengBMCWorld Journal of Emergency Surgery1749-79222017-07-011211610.1186/s13017-017-0140-7Delta neutrophil index as an early predictor of acute appendicitis and acute complicated appendicitis in adultsDong Hyuk Shin0Young Suk Cho1Gyu Chong Cho2Hee Cheol Ahn3Seung Min Park4Seung Wook Lim5Young Taeck Oh6Ji Woong Cho7Sang O. Park8Young Hwan Lee9Department of Emergency Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of MedicineDepartment of Emergency Medicine, School of Medicine, Kangdong Sacred Heart Hospital, Hallym UniversityDepartment of Emergency Medicine, School of Medicine, Kangdong Sacred Heart Hospital, Hallym UniversityDepartment of Emergency Medicine, Sacred Heart Hospital, Hallym University School of MedicineDepartment of Emergency Medicine, Sacred Heart Hospital, Hallym University School of MedicineDepartment of Emergency Medicine, Sacred Heart Hospital, Hallym University School of MedicineDepartment of Emergency Medicine, Sacred Heart Hospital, Hallym University School of MedicineDepartment of Surgery, Kangnam Sacred Heart Hospital, Hallym University Medical Center, Hallym University College of MedicineDepartment of Emergency Medicine, School of Medicine, Konkuk University Konkuk University Medical CenterDepartment of Emergency Medicine, Sacred Heart Hospital, Hallym University School of MedicineAbstract Background This retrospective study aimed to evaluate the ability of the delta neutrophil index (DNI) to predict histologically normal appendicitis preoperatively and to differentiate between simple and complicated appendicitis. Methods The data from 650 patients were divided into positive and negative appendectomy groups (histologically normal appendicitis). The patients in the acute appendicitis group were further sub-divided into simple and complicated appendicitis groups. Results The DNI was significantly higher in the positive group than in the negative appendectomy group (0.4 vs. −0.4, p < 0.001) as well as in the complicated group compared with that in the simple appendicitis group (1.2 vs. 0.3, p < 0.001). The DNI independently predicted a positive appendectomy and an acute complicated appendicitis in multivariate logistic regression analysis [odds ratio (OR) 2.62, 95% confidence interval (CI) (1.11~6.16), p = 0.028 and odds ratio (OR) 4.10, 95% confidence interval (CI) (2.94~5.80), p < 0.001]. The optimum cut-off for a positive appendectomy and acute complicated appendicitis were 0.2 [area under curve (AUC) 0.709] and 0.6 (AUC 0.727). Conclusions We suggest that obtaining a preoperative DNI is a useful parameter to aid in the diagnosis of histologically normal appendicitis and to differentiate between simple and complicated appendicitis.http://link.springer.com/article/10.1186/s13017-017-0140-7AppendicitisComplicated appendicitisDelta neutrophil index
collection DOAJ
language English
format Article
sources DOAJ
author Dong Hyuk Shin
Young Suk Cho
Gyu Chong Cho
Hee Cheol Ahn
Seung Min Park
Seung Wook Lim
Young Taeck Oh
Ji Woong Cho
Sang O. Park
Young Hwan Lee
spellingShingle Dong Hyuk Shin
Young Suk Cho
Gyu Chong Cho
Hee Cheol Ahn
Seung Min Park
Seung Wook Lim
Young Taeck Oh
Ji Woong Cho
Sang O. Park
Young Hwan Lee
Delta neutrophil index as an early predictor of acute appendicitis and acute complicated appendicitis in adults
World Journal of Emergency Surgery
Appendicitis
Complicated appendicitis
Delta neutrophil index
author_facet Dong Hyuk Shin
Young Suk Cho
Gyu Chong Cho
Hee Cheol Ahn
Seung Min Park
Seung Wook Lim
Young Taeck Oh
Ji Woong Cho
Sang O. Park
Young Hwan Lee
author_sort Dong Hyuk Shin
title Delta neutrophil index as an early predictor of acute appendicitis and acute complicated appendicitis in adults
title_short Delta neutrophil index as an early predictor of acute appendicitis and acute complicated appendicitis in adults
title_full Delta neutrophil index as an early predictor of acute appendicitis and acute complicated appendicitis in adults
title_fullStr Delta neutrophil index as an early predictor of acute appendicitis and acute complicated appendicitis in adults
title_full_unstemmed Delta neutrophil index as an early predictor of acute appendicitis and acute complicated appendicitis in adults
title_sort delta neutrophil index as an early predictor of acute appendicitis and acute complicated appendicitis in adults
publisher BMC
series World Journal of Emergency Surgery
issn 1749-7922
publishDate 2017-07-01
description Abstract Background This retrospective study aimed to evaluate the ability of the delta neutrophil index (DNI) to predict histologically normal appendicitis preoperatively and to differentiate between simple and complicated appendicitis. Methods The data from 650 patients were divided into positive and negative appendectomy groups (histologically normal appendicitis). The patients in the acute appendicitis group were further sub-divided into simple and complicated appendicitis groups. Results The DNI was significantly higher in the positive group than in the negative appendectomy group (0.4 vs. −0.4, p < 0.001) as well as in the complicated group compared with that in the simple appendicitis group (1.2 vs. 0.3, p < 0.001). The DNI independently predicted a positive appendectomy and an acute complicated appendicitis in multivariate logistic regression analysis [odds ratio (OR) 2.62, 95% confidence interval (CI) (1.11~6.16), p = 0.028 and odds ratio (OR) 4.10, 95% confidence interval (CI) (2.94~5.80), p < 0.001]. The optimum cut-off for a positive appendectomy and acute complicated appendicitis were 0.2 [area under curve (AUC) 0.709] and 0.6 (AUC 0.727). Conclusions We suggest that obtaining a preoperative DNI is a useful parameter to aid in the diagnosis of histologically normal appendicitis and to differentiate between simple and complicated appendicitis.
topic Appendicitis
Complicated appendicitis
Delta neutrophil index
url http://link.springer.com/article/10.1186/s13017-017-0140-7
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