KBB-Forum 2022 , Cilt 21, Sayı 4

THE DELTA NEUTROPHIL INDEX AS A PREDICTIVE MARKER IN DEEP NECK SPACE INFECTIONS

Nagihan GÜLHAN YAŞAR 1, MD; Ayşe Seçil KAYALI DİNÇ 1, MD; Melih ÇAYÖNÜ 1, MD; Süleyman BOYNUEĞRİ 1, MD; Elvan Evrim ÜNSAL TUNA 1, MD;
1Ankara Şehir Hastanesi, KBB Kliniği, Ankara, Turkey Background: Delta neutrophil index (DNI) has recently been introduced as a useful marker for predicting infection and sepsis. No study has yet evaluated DNI as an inflammation marker in deep neck infections

Aims: The aim to investigate DNI as an early predictive marker for distinguishing abscess and phlegmon in patients with deep neck space infections.

Methods: Totally 43 patients with DNSI divided into two groups (abscess (N:23) and phlegmon (N:20)) according to the presence of the pus after drainage. Length of hospital stay(LOS), laboratory tests such as white blood cell (WBC), neutrophil (NEU), lymphocyte (LYM) counts, neutrophil-lymphocyte ratio (NLR), delta neutrophil index (DNI) and inflammatory markers; procalcitonin (PCT), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) of the groups were compared.

Results: DNI and LOS were significantly higher in the abscess group (p<0,05). Other inflammatory markers (CRP, PCT, ESR) were higher in the abscess group compared to phlegmon but the difference between these values was not statistically significant(p>0,05). The optimum cut-off value of DNI was 0,95% to predict the presence of an abscess. The sensitivity and specificity of DNI were 60,9% and 75% respectively.

Conclusion: DNI stands out as an effective parameter in determining the presence of an abscess in patients with deep neck infection and evaluating the prognosis of the disease. DNI can help in clinical diagnosis with acceptable sensitivity and specificity in the process of differentiating between abscess and phlegmon in patients with deep neck infection and making the decision to perform surgery. Keywords : Deep Neck Infection, Abscess, Phlegmon, Delta Neutrophil Index