A Usefulness of Delta Neutrophil Index (DNI) for Prediction of 28 Day Mortality in Patients with Pneumonia- Induced Sepsis in the Intensive Care Unit

Background: The delta neutrophil index (DNI) represents the immature granulocyte fraction and is determined by subtracting the fraction of mature polymorphonuclear leucocytes from the sum of myeloperoxidase-reactive cells. The DNI has been proposed as a useful prognostic marker of sepsis. This study evaluated the clinical utility of DNI as a predictive marker in patients with pneumonia-induced sepsis in the intensive care unit (ICU). Materials & Methods: We conducted a retrospective study of pneumonia-induced sepsis in patients who were admitted to the Kangdong Sacred Heart Hospital’s medical ICUs from January 2013 to March 2015. The DNI was measured on three consecutive days after ICU admission. The primary outcome of this study was the 28-day mortality. Results: A total of 89 patients with pneumonia-induced sepsis were included in this study (41 patients with septic shock). In multivariate cox proportional analysis, sepsis (odds ratio (OR) of 0.012 ; 95% CI of 0.001-0.188 ;P = 0.002), and DNI 3 (OR 1.708; 95% CI 1.010–1.150; P = 0.048) were the risk factors for 28-day mortality were significantly related with 28-day mortality. Patients with higher DNI 3 (≥3) showed higher 28-day mortality than patients with lower DNI< 3 (53.8% vs 15.7%; P < 0.001) Conclusion: DNI at 72 hours after ICU admission is a promising prognostic marker of 28-day mortality in patients with pneumonia-induced sepsis in the ICU.