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

• Published in: World journal of emergency surgery Vol. 12; no. 1; p. 32
• Main Authors: Shin, Dong Hyuk, Cho, Young Suk, Cho, Gyu Chong, Ahn, Hee Cheol, Park, Seung Min, Lim, Seung Wook, Oh, Young Taeck, Cho, Ji Woong, Park, Sang O, Lee, Young Hwan
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 24.07.2017; BioMed Central; BMC
• Subjects: Age; Appendectomy; Appendicitis; Automation; Blood platelets; Blood tests; Clinical trials; Comparative analysis; Complicated appendicitis; Delta neutrophil index; Diagnosis; Granulocytes; Health aspects; Hematology; Hospitals; Laboratories; Lymphocytes; Measurement; Neutrophils; Physiological aspects; Proteins; Sepsis; Statistical analysis; South Korea; Delta neutrophil index; Appendicitis; Complicated appendicitis
• ISSN: 1749-7922; 1749-7922
• DOI: 10.1186/s13017-017-0140-7

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. 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. The DNI was significantly higher in the positive group than in the negative appendectomy group (0.4 vs. -0.4,  < 0.001) as well as in the complicated group compared with that in the simple appendicitis group (1.2 vs. 0.3,  < 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),  = 0.028 and odds ratio (OR) 4.10, 95% confidence interval (CI) (2.94~5.80),  < 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). 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.