Open AccessDelta neutrophil index: A reliable marker to differentiate perforated appendicitis from non‐perforated appendicitis in the elderly
Author(s) -
Shin Dong Hyuk,
Cho Young Suk,
Kim Yoon Sung,
Ahn Hee Cheol,
Oh Young Taeck,
Park Sang O.,
Won MooHo,
Cho Jun Hwi,
Kim Young Myeong,
Seo Jeong Yeol,
Lee Young Hwan
Publication year - 2018
Publication title -
journal of clinical laboratory analysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.536
H-Index - 50
eISSN - 1098-2825
pISSN - 0887-8013
DOI - 10.1002/jcla.22177
Subject(s) - medicine , perforation , odds ratio , confidence interval , gastroenterology , appendicitis , receiver operating characteristic , logistic regression , retrospective cohort study , acute appendicitis , appendix , area under the curve , predictive value of tests , surgery , paleontology , biology , materials science , punching , metallurgy
Background Delta neutrophil index ( DNI ) is a new inflammatory marker and the present study aimed to evaluate the predictive value of the DNI for the presence of a perforation in elderly with acute appendicitis. Methods This retrospective observational study was conducted on 108 consecutive elderly patients (≥65 years old) with acute appendicitis treated over a 24‐month period. Results Sixty‐nine of the 108 patients (median, IQR : 72, 67‐77 years) were allocated to the perforated appendicitis group (63.9%) and 39 to the non‐perforated appendicitis group (36.1%). WBC , neutrophil‐to‐lymphocyte ratio, platelet‐to‐lymphocyte ratio and DNI were significantly higher in the perforated group. In multiple logistic regression analyses, initial DNI was the only independent marker that can significantly predict the presence of perforation in multiple regression [odds ratio 9.38, 95% confidence interval (2.51‐35.00), P =.001]. Receiver operator characteristic curve analysis showed that DNI is a good predictor for the presence of appendiceal perforation at an optimal cut‐off for DNI being 1.4% (sensitivity 67.7%, specificity 90.0%, AUC 0.807). Conclusion Clinicians can reliably differentiate acute perforated appendicitis from non‐perforated appendicitis by DNI level of 1.4 or more in elderly patients.