Department of Otorhinolaryngology-Head and Neck Surgery, Konyang University College of Medicine, Daejeon, Republic of Korea.
Department of Biomedical Informatics, Konyang University College of Medicine, Daejeon, Republic of Korea.
Ear Nose Throat J. 2024 Jun;103(6):NP360-NP367. doi: 10.1177/01455613211058491. Epub 2021 Nov 24.
Predicting the need for surgical treatment among patients with chronic rhinosinusitis (CRS) is challenging. The delta neutrophil index (DNI) has been proposed as a useful laboratory marker of immature granulocytes, which indicates infection or severe inflammation in several diseases. This study evaluated DNI as an early predictor of the need for surgery in patients with CRS.
A total of 117 patients diagnosed with CRS were enrolled in this retrospective and observational study. Medical records, including symptoms data, WBC count, ESR level, LUC count, Lund-Mackay scores, and DNI, were reviewed. The receiver operating characteristic (ROC) curves were analyzed to determine the optimal cut-off values for predicting surgery.
Among 117 patients, 49 patients (41.9%) needed surgical intervention. The areas under the WBC, ESR, LUC, and DNI ROC curves were .571, .600, .592, and .782, respectively. The optimal cut-off value of DNI to predict surgery was .9%. The prognostic precision of DNI showed that the sensitivity was 59.2% and the specificity was 98.5%. In the analysis of risk factors, DNI levels were significantly associated with surgical intervention (odds ratio, 2.22; 95% confidence interval, 1.48-3.34; P < .01).
The level of DNI, which reflects the severity of the disease, may be a useful predictor for determining the need for surgical intervention in patients with CRS. This is the first literature to verify the role of DNI in upper airway disease.
预测慢性鼻-鼻窦炎（CRS）患者是否需要手术具有挑战性。δ中性粒细胞指数（DNI）已被提出作为不成熟粒细胞的有用实验室标志物，其在几种疾病中提示感染或严重炎症。本研究评估了 DNI 作为 CRS 患者手术需求的早期预测指标。
本回顾性观察性研究共纳入 117 例确诊为 CRS 的患者。回顾了病历，包括症状数据、WBC 计数、ESR 水平、LUC 计数、Lund-Mackay 评分和 DNI。分析了受试者工作特征（ROC）曲线，以确定预测手术的最佳截断值。
在 117 例患者中，有 49 例（41.9%）需要手术干预。WBC、ESR、LUC 和 DNI 的 ROC 曲线下面积分别为.571、.600、.592 和.782。预测手术的 DNI 最佳截断值为.9%。DNI 的预后精度表明，其敏感性为 59.2%，特异性为 98.5%。在危险因素分析中，DNI 水平与手术干预显著相关（比值比，2.22；95%置信区间，1.48-3.34；P<.01）。
反映疾病严重程度的 DNI 水平可能是预测 CRS 患者手术需求的有用指标。这是首次验证 DNI 在气道疾病中的作用的文献。
