Can the Delta Neutrophil Index be used as a marker to predict whether the ovaries are viable or not in cases of ovarian torsion before surgery?

Authors : Gamze Yılmaz, Hatice Akkaya

Pages : 56-61

Doi:10.38136/jgon.1594690

View : 23 | Download : 36

Publication Date : 2025-03-22

Article Type : Research Paper

Abstract :Aim: To assess the predictive capability of the preoperative Delta Neutrophil Index (DNI) value in deciding whether to pursue an ovarian-preserving approach. Materials and Methods: This retrospective cohort study was conducted on 81 women diagnosed with ovarian torsion. All patients underwent surgery, with 48 undergoing surgical detorsion and 33 undergoing oophorectomy. The latter group had available final pathology results. Patients were categorized based on final pathology results into groups with and without necrosis. None of the detorsion patients required reoperation within the first month. Surgery type , number of ovarian twists, preoperative admission hemogram parameters and final histological diagnosis were recorded, and it was evaluated whether the DNI values could be used as a predictive marker of ovarian viability in cases of ovarian torsion. Results: A DNI value cut-off of 0.70 yielded 95.7% specificity, 83.3% sensitivity, 97.1% negative predictive value, and 83.3% positive predictive value for predicting necrosis. For neutrophil to lymphocyte ratio (NLR) values, a cut-off of 7.53 resulted in 77% specificity, 91.7% sensitivity, 98% negative predictive value, and 39% positive predictive value for predicting necrosis. No significant association was observed between necrosis and ovarian enlargement, the duration of time between the initial onset of pain and surgery, or the number of adnexal twists. However, the necrosis group exhibited significantly higher leukocyte counts, especially neutrophil counts(p<0.01). Conclusion: Our study suggests that having DNI and NLR values lower than the preoperative total blood count cut-off levels may serve as valuable guidance to surgeons in assessing the absence of ovarian necrosis.
Keywords : over torsiyonu, delta nötrofil indeks, nekroz