PDF(Pubmed)
Abstract：
Purpose: This study aimed to assess the predictive accuracy of 30-day mortality with delta neutrophil index (DNI) in adult cardiac surgical patients. Methods: This study enrolled patients who underwent cardiac surgery under general anesthesia between March 2016 and May 2022 at a tertiary hospital in the Republic of Korea. DNI was measured preoperatively, on postoperative arrival to the surgical intensive care unit (ICU), and 12, 24, 48, and 72 h postoperatively. Receiver operating characteristic (ROC) analysis was employed to identify the prediction accuracy of DNI. An area under ROC curve (AUROC) ≥0.700 was defined as satisfactory predictive accuracy. An optimal cutoff point for the DNI value to maximize predictive accuracy was revealed in the ROC curve, where [sensitivity + specificity] was maximum. Results: This study included a total of 843 patients in the final analyses. The mean age of the study population was 66.9±12.2 years and 38.4% of them were female patients. The overall 30-day mortality rate was 5.2%. Surgery involving the thoracic aorta, history of prior cardiac surgery, or emergency surgery were associated with a higher mortality rate. The DNI showed satisfactory predictive accuracy at 24 h, 48 h, and 72 h postoperatively, with AUROC of 0.729, 0.711, and 0.755, respectively. The optimal cutoff points of DNI at each time point were 3.2, 3.8, and 2.3, respectively. Conclusions: Postoperative DNI is a good predictor of 30-day mortality after cardiac surgery and has the benefit of no additional financial costs or time.
摘要：
目的：本研究旨在评估成人心脏手术患者的delta中性粒细胞指数（DNI）对30天死亡率的预测准确性。方法：本研究纳入2016年3月至2022年5月在韩国一家三级医院接受全身麻醉心脏手术的患者。术前测量DNI，在术后到达外科重症监护病房（ICU）时，术后12、24、48和72h。采用接收器工作特性（ROC）分析来确定DNI的预测准确性。ROC曲线下面积(AUROC)≥0.700被定义为令人满意的预测准确性。在ROC曲线中揭示了DNI值最大化预测准确性的最佳截止点，其中[敏感性+特异性]最大。结果：本研究最终纳入843例患者。研究人群的平均年龄为66.9±12.2岁，其中38.4％为女性患者。总体30天死亡率为5.2%。涉及胸主动脉的手术,既往心脏手术史,或急诊手术与较高的死亡率相关.DNI在24h时显示出令人满意的预测准确性，48h,术后72小时，AUROC分别为0.729、0.711和0.755。DNI在每个时间点的最佳截止点分别为3.2、3.8和2.3。结论：术后DNI是心脏手术后30天死亡率的良好预测指标，并且没有额外的财务成本或时间。
