The objective: to study the prognostic significance of the ratio of the absolute number of neutrophils to lymphocytes (NLR) and platelets to lymphocytes (PLR) in assessing the risk of cardiovascular complications in non-cardiac surgical interventions.Subjects and Methods. 85 patients aged 66 [61‒70] years who underwent elective vascular surgery were examined.Results. Concomitant circulatory diseases were diagnosed in 98.8%. PLR < 91.2 with the sensitivity of 60% and the specificity of 67.8% was associated with diabetes mellitus (AUC – 0.686; 95% CI 0.576‒0.783, p = 0.0022). Cardiovascular complications were registered in 9.3% of patients. NLR was an independent predictor of cardiovascular complications: OR – 5.216; 95% CI 1.246‒21.826, p = 0.005. NLR > 2.1 discriminated cardiovascular complications with the sensitivity of 75% and specificity of 75% (AUC – 0.827; 95% CI 0.690–0.921; p = 0.004). PLR was also a predictor of cardiovascular complications: OR – 1.0111; 95% CI 1.0001–1.0223; p = 0.027. PLR > 105.5 allowed identifying patients with NT-proBNP > 650 pg/ml with the sensitivity of 75.0% and the specificity of 61.8% (AUC – 0.740; 95% CI 0.630‒0.832; p = 0.0308).Conclusion. NLR and PLR can be used to identify patients with increased cardiac risk when undergoing vascular surgery. Further research in this field is advisable.
Objective: To compare predictive accuracy of the American Society of Anesthesiologists (ASA) score and various cardiac risk indices for perioperative cardiovascular (CV) complications in patients undergoing noncardiac surgery.Materials and methods: We examined 243 patients (148 men and 95 women) aged 45 to 84 (66 [60-71] years) prior to their elective oncological and vascular surgery. We assessed patients using the ASA physical status classification system, Revised Cardiac Risk Index (RCRI), Gupta Myocardial Infarct or Cardiac Arrest (MICA) calculator, and Khoronenko cardiac risk index and analyzed perioperative CV complications.Results: We detected complications in 30 (12.3%) patients, with 3 (1.24%) of them having 2 concomitant CV complications. One death (0.41%) was registered. The MICA risk calculator had the highest predictive value (AUC ROC = 0.753). Risk scores over 0.95% discriminated patients with perioperative CV complications with sensitivity and specificity of 73.3% and 67.45%, respectively.Conclusions: We recommend using the MICA risk calculator to predict perioperative CV complications following elective oncological and vascular surgery.
The objective: to study information value of the neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) in the cardiac risk assessment in abdominal oncological surgery.Subjects and Methods. 94 patients of 68 [62‒73] years old who underwent elective surgery were examined.Results. Cardiovascular comortbidity was diagnosed in 69 (73.4%) patients. 11 (11.7%) perioperative cardiovascular complications were registered. Cardiac mortality was 4.3%. Hematological indices were not associated with cardiovascular diseases (NLR: OR = 0.59‒1.42; 95% CI 0.14‒2.60; p = 0.29‒0.74, PLR: OR = 0.99‒1.00; 95% CI 0.97‒1.01; p = 0.31‒0.99). NLR and PLR were not predictors of cardiovascular complications (OR = 0.67; 95% CI 0.19‒2.37; p = 0.46 and OR = 1.00; 95% CI 0.99‒1.01; p = 0.68) and cardiac death (OR = 0.21; 95% CI 0.01‒8.05; p = 0.23 and OR = 0.99; 95% CI 0.98‒1.01; p = 0.79).Conclusion. NLR and PLR cannot be recommended for the cardiac risk assessment in abdominal oncological surgery.
One of the approaches to increasing the effectiveness and safety of postoperative analgesia can be its personification. The goal of the study was to evaluate the efficacy of tramadol analgesia depending on the polymorphisms of the CYP2D6 gene, the cytochrome P-450 isoenzyme, involved in drug biotransformation into the active metabolite. 96 patients with elective endoscopic gynecology procedures were examined. Polymorphisms G1846A and C100T, which reduce the activity of the isoenzyme CYP2D6, were detected, and the intensity of postoperative pain, the autonomic nervous system state by cardiointervalography and hemostasis using rotational thromboelastometry were evaluated. Polymorphisms were detected in 29 (30.2%) patients, united in the 1-st group. The second group consisted of 67 patients without gene polymorphisms. Patients with polymorphisms have a higher pain scores; the frequency of postoperative nausea and vomiting, on the contrary, was significantly lower. According to cardiointervalography, sympathicotonia was observed in Group 1 patients after surgery, while in Group 2 patients the indices did not change significantly compared to baseline. The parameters of hemostasis in patients of the 2nd group were characterized by moderate hypercoagulability (shortening of clotting time and clot formation time), whereas in the firsts group, relative hypocoagulation (decrease in α angle, and clot firmness) was noted. Conclusion. In female carriers of G1846A and C100T polymorphisms of the CYP2D6 gene, the effectiveness of post-operative analgesia based on tramadol is reduced. They have a lower incidence of postoperative nausea and vomiting, and moderate hypocoagulation. Probably, these phenomena are associated with a change in the ratio between the drug and its active metabolite - O-desmethyltramadol.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.