Usefulness of delta neutrophil index for early prediction of overt disseminated intravascular coagulopathy in patients with venomous snakebite
Objective Clinically, consumptive coagulopathy, such as disseminated intravascular coagulopathy (DIC), is the most important among the common venomous snakebite complications owing to the serious hemorrhage risk associated with this condition. We evaluated the predictive value of the delta neutrophi...
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| Format: | Article |
| Language: | English |
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The Korean Society of Emergency Medicine
2018-06-01
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| Series: | Clinical and Experimental Emergency Medicine |
| Subjects: | |
| Online Access: | http://www.ceemjournal.org/upload/pdf/ceem-16-195.pdf |
| _version_ | 1797895639693000704 |
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| author | Yong Sung Cha Kang Hyun Lee Seok Jeong Lee Ho Chul Kwon Jong Wook Lee Hyung Il Kim Oh Hyun Kim Kyoung-Chul Cha Hyun Kim Sung Oh Hwang |
| author_facet | Yong Sung Cha Kang Hyun Lee Seok Jeong Lee Ho Chul Kwon Jong Wook Lee Hyung Il Kim Oh Hyun Kim Kyoung-Chul Cha Hyun Kim Sung Oh Hwang |
| author_sort | Yong Sung Cha |
| collection | DOAJ |
| description | Objective Clinically, consumptive coagulopathy, such as disseminated intravascular coagulopathy (DIC), is the most important among the common venomous snakebite complications owing to the serious hemorrhage risk associated with this condition. We evaluated the predictive value of the delta neutrophil index (DNI)—a new indicator for immature granulocytes—for DIC diagnosis. Methods This retrospective observational study consecutively assessed adult patients with venomous snakebites for over 51 months. Patients were categorized into the no DIC and DIC groups. DNI values were measured within 24 hours after snakebite. Results Thirty patients (26.3%) developed DIC. The DIC group had significantly higher median initial DNI than the no DIC group (0% vs. 0.2%, P<0.001). When the DIC group was divided into early and late groups (within and over 24 hours after snakebite, respectively), the DNI of the former was significantly higher than that of the latter and no DIC group. The late DIC group had significantly higher DNI than the no DIC group. Furthermore, DNI positively correlated with the DIC score (r=0.548, P<0.001). The initial DNI (odds ratio, 4.449; 95% confidence interval, 1.738 to 11.388; P=0.002) was an early DIC predictor. The area under the curve based on the initial DNI’s receiver operating characteristic curve was 0.724. Conclusion DNI values were significantly higher in the DIC group. Additionally, DNI was an early predictor of DIC development in patients with venomous snakebites in the emergency department. |
| first_indexed | 2024-04-10T07:30:03Z |
| format | Article |
| id | doaj.art-afdd06301fca4fef91a20e83055b99b2 |
| institution | Directory Open Access Journal |
| issn | 2383-4625 |
| language | English |
| last_indexed | 2024-04-10T07:30:03Z |
| publishDate | 2018-06-01 |
| publisher | The Korean Society of Emergency Medicine |
| record_format | Article |
| series | Clinical and Experimental Emergency Medicine |
| spelling | doaj.art-afdd06301fca4fef91a20e83055b99b22023-02-24T01:21:07ZengThe Korean Society of Emergency MedicineClinical and Experimental Emergency Medicine2383-46252018-06-0152768310.15441/ceem.16.195183Usefulness of delta neutrophil index for early prediction of overt disseminated intravascular coagulopathy in patients with venomous snakebiteYong Sung Cha0Kang Hyun Lee1Seok Jeong Lee2Ho Chul Kwon3Jong Wook Lee4Hyung Il Kim5Oh Hyun Kim6Kyoung-Chul Cha7Hyun Kim8Sung Oh Hwang9 Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea Department of Laboratory Medicine, Jincheon Sungmo Hospital, Jincheon, Korea Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, KoreaObjective Clinically, consumptive coagulopathy, such as disseminated intravascular coagulopathy (DIC), is the most important among the common venomous snakebite complications owing to the serious hemorrhage risk associated with this condition. We evaluated the predictive value of the delta neutrophil index (DNI)—a new indicator for immature granulocytes—for DIC diagnosis. Methods This retrospective observational study consecutively assessed adult patients with venomous snakebites for over 51 months. Patients were categorized into the no DIC and DIC groups. DNI values were measured within 24 hours after snakebite. Results Thirty patients (26.3%) developed DIC. The DIC group had significantly higher median initial DNI than the no DIC group (0% vs. 0.2%, P<0.001). When the DIC group was divided into early and late groups (within and over 24 hours after snakebite, respectively), the DNI of the former was significantly higher than that of the latter and no DIC group. The late DIC group had significantly higher DNI than the no DIC group. Furthermore, DNI positively correlated with the DIC score (r=0.548, P<0.001). The initial DNI (odds ratio, 4.449; 95% confidence interval, 1.738 to 11.388; P=0.002) was an early DIC predictor. The area under the curve based on the initial DNI’s receiver operating characteristic curve was 0.724. Conclusion DNI values were significantly higher in the DIC group. Additionally, DNI was an early predictor of DIC development in patients with venomous snakebites in the emergency department.http://www.ceemjournal.org/upload/pdf/ceem-16-195.pdfsnake bitesdisseminated intravascular coagulopathydiagnosisbiomarker |
| spellingShingle | Yong Sung Cha Kang Hyun Lee Seok Jeong Lee Ho Chul Kwon Jong Wook Lee Hyung Il Kim Oh Hyun Kim Kyoung-Chul Cha Hyun Kim Sung Oh Hwang Usefulness of delta neutrophil index for early prediction of overt disseminated intravascular coagulopathy in patients with venomous snakebite Clinical and Experimental Emergency Medicine snake bites disseminated intravascular coagulopathy diagnosis biomarker |
| title | Usefulness of delta neutrophil index for early prediction of overt disseminated intravascular coagulopathy in patients with venomous snakebite |
| title_full | Usefulness of delta neutrophil index for early prediction of overt disseminated intravascular coagulopathy in patients with venomous snakebite |
| title_fullStr | Usefulness of delta neutrophil index for early prediction of overt disseminated intravascular coagulopathy in patients with venomous snakebite |
| title_full_unstemmed | Usefulness of delta neutrophil index for early prediction of overt disseminated intravascular coagulopathy in patients with venomous snakebite |
| title_short | Usefulness of delta neutrophil index for early prediction of overt disseminated intravascular coagulopathy in patients with venomous snakebite |
| title_sort | usefulness of delta neutrophil index for early prediction of overt disseminated intravascular coagulopathy in patients with venomous snakebite |
| topic | snake bites disseminated intravascular coagulopathy diagnosis biomarker |
| url | http://www.ceemjournal.org/upload/pdf/ceem-16-195.pdf |
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