INTRODUCTION: This report is dedicated to the delta neutrophil index (DNI) as a laboratory indicator reflecting circulating immature granulocytes, and its application as a diagnostic and prognostic marker in sepsis, severe infections and other acute inflammatory conditions.
AIM: The aim is to analyze, systematize and interpret data from the available scientific literature regarding the biological nature of DNI, its calculation method, clinical areas of application, its diagnostic accuracy, its prognostic value, and the main limitations in its interpretation in order to refine its use in the diagnosis and treatment of inflammatory diseases in the domain of oral and maxillofacial surgery.
MATERIALS AND METHODS: The text is a qualitative analytical review with a thematic synthesis of the used literature sources, including systematic reviews, meta-analyses, diagnostic studies, clinical observations, and publications on specific populations and acute clinical conditions.
RESULTS AND DISCUSSION: The reviewed sources show that DNI is an automatically generated indicator by certain hematology analyzers that reflects the fraction of immature granulocytes in peripheral blood. The cited scientific works consistently associate elevated DNI with severe infection, sepsis, and early inflammatory deterioration, and in many studies it has demonstrated high specificity and good prognostic value for severity and mortality, especially in sepsis and critically ill patients. However, the studies included in the review also show significant variability in diagnostic thresholds, as well as limitations related to nonspecific elevation of the indicator and its different effectiveness in individual clinical populations.
CONCLUSION: The available scientific literature supports the view that DNI is a rapid, automated and clinically useful marker for early recognition of severe infection and for assessing the prognosis in sepsis and other acute inflammatory conditions, but its interpretation should be done in the context of the clinical picture and in combination with other laboratory indicators, and not as a standalone diagnostic test. All this gives reason to assume that DNI can also be used in the diagnosis, treatment, and follow-up of patients with acute infectious diseases of the nature of oral and maxillofacial surgery.
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