Perioperative neutrophil to lymphocyte ratio as a predictor of poor cardiac surgery patient outcomes.

IF 2.3 Q2 MEDICINE, GENERAL & INTERNAL Pragmatic and Observational Research Pub Date : 2017-02-15 eCollection Date: 2017-01-01 DOI:10.2147/POR.S130560
Konstantinos Giakoumidakis, Nikolaos V Fotos, Athina Patelarou, Stavros Theologou, Mihalis Argiriou, Anastasia A Chatziefstratiou, Christina Katzilieri, Hero Brokalaki
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引用次数: 18

Abstract

Purpose: The purpose of the present study was to investigate the association between the perioperative neutrophil to lymphocyte ratio (NLR) and cardiac surgery patient outcomes.

Patients and methods: A retrospective cohort study of 145 patients who underwent cardiac surgery in a tertiary hospital of Athens, Greece, from January to March 2015, was conducted. By using a structured short questionnaire, this study reviewed the electronic hospital database and the medical and nursing patient records for data collection purposes. The statistical significance was two-tailed, and p-values <0.05 were considered significant. The statistical analysis was performed with Mann-Whitney U test and Spearman's correlation coefficient, by using the Statistical Package for Social Sciences software (IBM SPSS 21.0 for Windows).

Results: The increased preoperative levels of NLR were associated with significantly higher mortality, both in-hospital (p=0.001) and 30-day (p=0.002), prolonged postoperative hospital length of stay (LOS), both in the cardiac intensive care unit (ICU) (p=0.002), and in-hospital (p=0.018), and likewise with delayed tracheal extubation (p≤0.001). Furthermore, patients with elevated NLR during the second postoperative day had significantly higher in-hospital mortality (p=0.018), increased incidence of pneumonia (p=0.022), higher probability of readmission to the ICU (p=0.002), prolonged ICU LOS (p≤0.001), and delayed tracheal extubation (p≤0.001).

Conclusion: Increased perioperative NLR seems to be associated with significantly higher mortality and morbidity in cardiac surgery patients. At the same time, NLR is a significant and inexpensive biomarker for the early identification of patients at high risk for complications. In addition, NLR levels could lead clinicians to perform measures for the optimal therapeutic patient approach.

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围手术期中性粒细胞与淋巴细胞比值作为心脏手术患者预后不良的预测因子。
目的:本研究的目的是探讨围手术期中性粒细胞与淋巴细胞比值(NLR)与心脏手术患者预后的关系。患者与方法:对2015年1 - 3月在希腊雅典某三级医院行心脏手术的145例患者进行回顾性队列研究。本研究采用一份结构化的简短问卷,检视医院电子资料库及医疗护理病患纪录,以收集资料。采用社会科学统计软件包(IBM SPSS 21.0 for Windows)进行统计显著性双尾检验,p值U检验和Spearman相关系数检验。结果:术前NLR水平升高与住院死亡率(p=0.001)和30天死亡率(p=0.002)、术后住院时间(LOS)延长(心脏重症监护病房(ICU) (p=0.002)和住院时间(p=0.018)以及气管拔管延迟(p≤0.001)显著相关。此外,术后第2天NLR升高的患者住院死亡率(p=0.018)、肺炎发生率增加(p=0.022)、再次入住ICU的概率更高(p=0.002)、ICU LOS延长(p≤0.001)和气管拔管延迟(p≤0.001)。结论:围手术期NLR的增加似乎与心脏手术患者的死亡率和发病率显著升高有关。同时,NLR是一种重要且廉价的生物标志物,可用于早期识别高危并发症患者。此外,NLR水平可以引导临床医生为最佳治疗患者方法执行措施。
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Pragmatic and Observational Research
Pragmatic and Observational Research MEDICINE, GENERAL & INTERNAL-
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期刊介绍: Pragmatic and Observational Research is an international, peer-reviewed, open-access journal that publishes data from studies designed to closely reflect medical interventions in real-world clinical practice, providing insights beyond classical randomized controlled trials (RCTs). While RCTs maximize internal validity for cause-and-effect relationships, they often represent only specific patient groups. This journal aims to complement such studies by providing data that better mirrors real-world patients and the usage of medicines, thus informing guidelines and enhancing the applicability of research findings across diverse patient populations encountered in everyday clinical practice.
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