A Usefulness of Delta Neutrophil Index (DNI) for Prediction of 28 Day Mortality in Patients with Pneumonia-Induced Sepsis in the Intensive Care Unit
Abstract
1. Introduction
2. Materials and Methods
2.1. Patients
2.2. Data Collection
2.3. Definitions
2.4. Statistical Analysis
3. Results
3.1. Patient Characteristics
3.2. Factors Associated with 28-Day Mortality
3.3. Subgroup Analysis of Delta Neutrophil Index (DNI) as Predictor of 28-Day Mortality
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variables | No. of Patients (%) or Mean ± SD (n = 227) |
---|---|
Age | 74 ± 13.7 |
Sex (Male) | 150 (66.1%) |
Septic shock | 116 (51.1%) |
Cormobidities | |
DM | 124 (54.6%) |
HTN | 79 (34.8%) |
Heart Disease | 32 (14.1%) |
Stroke | 14 (6.2%) |
COPD | 36 (15.9%) |
IPF * | 12 (4.8%) |
Dementia | 24(10.6%) |
Chronic Liver Disease | 27 (11.9%) |
Solid cancer | 32 (14.1%) |
Severity at ICU admission | |
APACHE II | 22.0 ± 5.9 |
Treatment in ICU | |
Mechanical ventilation | 129 (56.8%) |
Tracheostomy | 87 (38.3%) |
CRRT | 25 (11.0%) |
ECMO | 5 (2.2%) |
ILA | 4 (1.7%) |
Laboratory findings | No. of Patients (%) or Mean ± SD |
WBC (103/uL) | 13,227.8 ± 7864.3 |
Hb (g/dL) | 11.8 ± 3.1 |
Platelet (103/uL) | 244.6 ± 133.9 |
Neutrophil (%) | 79.1 ± 16.5 |
DNI 1 (%) | 6.9 ± 12.9 |
DNI 2 (%) | 5.9 ± 12.0 |
DNI 3 (%) Combined DNI (%) | 4.9 ± 12.5 17.6 ± 33.5 |
Lymphocyte (%) | 15.4 ± 15.3 |
Na (mEq/L) | 137.2 ± 10.0 |
K (mEq/L) | 4.2 ± 0.8 |
BUN (mg/dL) | 28.4 ± 21.0 |
Cr (mg/dL) | 1.4 ± 2.2 |
AST (IU/L) | 67.4 ± 213.9 |
ALT (IU/L) | 41.5 ± 123.1 |
BNP (pg/mL) | 371.7 ± 564.5 |
CRP (mg/dL) | 125.4 ± 108.6 |
Procalcitonin (ng/mL) | 5.2 ± 16.9 |
Lactic acid (mmol/L) | 3.4 ± 3.8 |
Variables | Survivors (N = 181) | Non Survivors (N = 46) | p-Value |
---|---|---|---|
Age | 73.1 ± 13.8 | 77.6 ± 13.1 | 0.05 |
Sex (Male, %) | 115 (63.5) | 35 (76.1) | 0.15 |
Septic shock | 98 (54.1) | 28 (60.9) | 0.09 |
Severity scores | |||
APACHE | 21.7 ± 5.9 | 23.3 ± 6.1 | 0.10 |
Treatment in ICU | |||
MV | 97 (53.6) | 32 (69.6) | 0.07 |
CRRT | 19 (10.5) | 22 (47.8) | 0.82 |
ECMO | 2 (1.1) | 2 (4.3) | 0.57 |
ILA | 3 (1.6) | 2 (4.3) | 0.64 |
Tracheostomy | 69 (38.1) | 18 (39.1) | 0.98 |
Laboratory findings | |||
WBC (103/uL) | 12,998.0 ± 7834.8 | 14,132.0 ± 8001.2 | 0.39 |
Neutrophil (%) | 80.5 ± 14.5 | 73.6 ± 22.0 | 0.05 |
DNI 1 (%) | 5.8 ± 12.4 | 11.4 ± 13.8 | 0.01 |
DNI 2 (%) | 3.8 ± 9.2 | 14.5 ± 17.1 | 0.00 |
DNI 3 (%) | 2.3 ± 8.6 | 14.9 ± 19.0 | 0.00 |
Combined DNI (%) | 4.6 (0.6–12.3) | 21.5 (5.7–67.0) | 0.00 |
Lymphocyte | 13.1 ± 8.6 | 10.0 ± 4.8 | 0.04 |
Hb (g/dL) | 11.8 ± 3.2 | 11.5 ± 2.5 | 0.48 |
Platelet(103/uL) | 248.3 ± 138.0 | 229.9 ± 116.8 | 0.36 |
Na (mEq/L) | 136.9 ± 9.9 | 138.4 ± 10.4 | 0.39 |
K (mEq/L) | 4.6 ± 0.9 | 4.1 ± 0.8 | 0.06 |
BUN (mg/dL) | 36.8 ± 25.0 | 26.3 ± 19.3 | 0.07 |
Cr (mg/dL) | 1.5 ± 1.3 | 1.4 ± 2.4 | 0.53 |
AST (IU/L) | 140.5 ± 460.2 | 48.8 ± 52.8 | 0.18 |
ALT (IU/L) | 68.0 ± 226.5 | 34.8 ± 77.3 | 0.33 |
BNP (pg/mL) | 128.5 ± 106.5 | 124.7 ± 109.4 | 0.83 |
CRP (mg/dL) | 6.0 ± 14.6 | 5.0 ± 17.5 | 0.69 |
Procalcitonin (ng/mL) | 446.8 ± 546.4 | 352.3 ± 569.0 | 0.32 |
Lactic acid (mmol/L) | 5.5 ± 5.6 | 2.8 ± 2.9 | 0.00 |
Variables | Odds Ratio (95% CI) | p-Value |
---|---|---|
Age | 0.97 (0.94, 1.0) | 0.03 |
Sex | 1.98 (0.81, 4.81) | 0.13 |
Lymphocyte | 0.99 (0.96,1.01) | 0.29 |
DNI 1 | 1.04 (0.98, 1.1) | 0.17 |
DNI 2 | 0.97 (0.9, 1.05) | 0.51 |
DNI 3 | 0.95 (0.89, 0.99) | 0.05 |
Lactic acid | 0.86 (0.78, 0.95) | 0.00 |
Coeff. (95%CI) | p Value | |
---|---|---|
DNI 1 | ||
≥70 | −4.23 (−9.2, 0.73) | 0.097 |
<70 | −11.67 (−19.6, −3.74) | 0.005 |
DNI 2 | ||
≥70 | −8.93 (−13.43, −4.43) | <0.001 |
<70 | −19.38 (−25.83, −12.94) | <0.001 |
DNI 3 | ||
≥70 | −10.47 (−14.74, −6.2) | <0.001 |
<70 | −23.76 (−31.67, −15.86) | <0.001 |
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Moon, S.; Park, Y.; Hong, C.-W.; Park, S.; Sim, Y.; Ko, Y.; Park, S. A Usefulness of Delta Neutrophil Index (DNI) for Prediction of 28 Day Mortality in Patients with Pneumonia-Induced Sepsis in the Intensive Care Unit. J. Clin. Med. 2025, 14, 2002. https://doi.org/10.3390/jcm14062002
Moon S, Park Y, Hong C-W, Park S, Sim Y, Ko Y, Park S. 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. 2025; 14(6):2002. https://doi.org/10.3390/jcm14062002
Chicago/Turabian StyleMoon, SooYoon, YongBum Park, Chang-Won Hong, Sunghoon Park, YunSu Sim, Yousang Ko, and SoYoung Park. 2025. "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 14, no. 6: 2002. https://doi.org/10.3390/jcm14062002
APA StyleMoon, S., Park, Y., Hong, C.-W., Park, S., Sim, Y., Ko, Y., & Park, S. (2025). 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, 14(6), 2002. https://doi.org/10.3390/jcm14062002