The Usefulness of the Delta Neutrophil Index for Predicting Superimposed Pneumonia in Patients with Acute Decompensated Heart Failure in the Emergency Department

Although respiratory infections, such as pneumonia, have long been recognized as precipitators of exacerbation in patients with acute decompensated heart failure (ADHF), identifying signs of concomitant pneumonia in ADHF is a clinical diagnostic challenge. We evaluated the predictive value of the de...

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Bibliographic Details
Published in:PloS one 2016-09, Vol.11 (9), p.e0163461-e0163461
Main Authors: Cha, Yong Sung, Lee, Kang Hyun, Lee, Jong Wook, Kwon, Woocheol, Lee, Seok Jeong, Kang, Kyung Sik, Kim, Hyung Il, Kim, Oh Hyun, Cha, Kyoung-Chul, Kim, Hyun, Hwang, Sung Oh
Format: Article
Language:English
Subjects:
Analysis
Antibiotics
Bacterial infections
Biology and Life Sciences
C-reactive protein
Confidence intervals
Diagnostic equipment (Medical)
Diagnostic systems
Emergency medical care
Emergency medical services
Granulocytes
Health aspects
Heart
Heart diseases
Heart failure
Hospital emergency services
Hospitals
Infections
Internal medicine
Leukocytes
Leukocytes (granulocytic)
Medical research
Medical schools
Medicine
Medicine and Health Sciences
Natriuretic peptides
Neutrophils
Patients
Pneumonia
Precipitators
Predictions
Proteins
Regression analysis
Statistical analysis
Systematic review
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Summary:Although respiratory infections, such as pneumonia, have long been recognized as precipitators of exacerbation in patients with acute decompensated heart failure (ADHF), identifying signs of concomitant pneumonia in ADHF is a clinical diagnostic challenge. We evaluated the predictive value of the delta neutrophil index (DNI), a new indicator for immature granulocytes, for diagnosing superimposed pneumonia in patients presenting with ADHF in the emergency department (ED). This was a retrospective and observational study of consecutive patients (>18 years old) diagnosed with an ADHF in the ED over a 7-month period. Patients were categorized into either the ADHF group or the ADHF with pneumonia group. DNI, serum white blood cell (WBC), C-reactive protein (CRP), and β-natriuretic peptide (BNP) were measured upon ED arrival. The ADHF with pneumonia group included 30 patients (20.4%). Median initial DNI, WBC, and CRP were significantly higher in the ADHF with pneumonia group [0% vs. 1.8%, p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0163461