Incidence of neurological complications following pediatric heart surgery and its association with neutrophil‐to‐lymphocyte ratio

Abstract

Background and Aims Due to increased rate of open‐heart surgeries in children, postsurgical mortality and morbidities have increasingly gained attention. Neurological complications are some of the most important postsurgical events. However, the number of studies regarding postsurgical neurological complications seems to be inadequate. We aimed to study the incidence of neurological complications following cardiac surgery in the pediatric cardiac intensive care unit (ICU) of the children's medical center. Methods This cross‐sectional study was conducted from March to September 2019. We included all of the children who underwent cardiac surgery and were admitted to ICU at CMC. We collected their demographic data, lab test results (white blood cell count, absolute neutrophile and lymphocyte counts) and calculated their Risk Adjustment for Congenital Heart Surgery (RACHS) score. We then documented neurological adverse events and investigated the associations between those events and the patients' data. Results Of the 267 studied patients, 14 developed neurological complications (5.2%); seven developed chorea (2.6%), four developed seizures (1.5%), and two developed both seizure and chorea (0.7%). One case developed subarachnoid hemorrhage (SAH). We observed that age ( p = 0.000), weight ( p = 0.000), and RACHS score ( p = 0.006) were associated with the development of neurological complications. Additionally, we observed that “neutrophil to lymphocyte ratio” was not associated with the risk of postsurgical neurological complications. Conclusion Younger age, lower weight, and higher RACHS score were associated with neurological complications after operations. Given the importance of postsurgical neurological complications, further investigations should be carried out to cover this issue and discover preventive strategies for such morbidities.

Risk factors for neurological complications and short-term outcomes after pediatric heart surgery: a retrospective analysis

“…Pediatric cardiac surgery is a complex and high-risk procedure that aims to correct congenital heart defects in children [ 5 , 6 ]. While the surgery has a high success rate, there is a risk of neurological complications in some patients [ 8 ].…”

“…However, we insignificant association between CNS insult and age (p > 0.05). While, in a study by Abdshah et al conducted at Tehran found age was significantly associated with neurological complications [ 6 ]. Another study by Andropoulos et al reported that infants under three months of age had greater risk of neurological complications [ 14 ].…”

“…The mortality rate in children following cardiac surgery has decreased over the course of the past decade due to improvements in prenatal diagnosis, perioperative treatment, and advanced bypass procedures. Despite this, it has led to an increase in the morbidities like neurological complications [ 5 , 6 ]. Complications occurred in 43 % of pediatric cardiac surgeries performed both with and without cardiopulmonary bypass [ 3 ].…”

Prevalence, risk factors, and outcomes of acute kidney injury in a pediatric cardiac intensive care unit: A cross‐sectional study

“…The survival of patients with congenital heart diseases has increased dramatically due to recent advances in cardiac surgery, yet morbidity rates remain high 1,2 . Acute kidney injury (AKI), defined as an abrupt decline in renal function, is a common complication in critically ill patients admitted to the pediatric cardiac intensive care unit (PCICU) 3,4 .…”

The characteristics of Guillain–Barre syndrome in children in pre‐COVID‐19 and during the COVID‐19 pandemic: A cross‐sectional study

“…Factors such as white blood cells (WBC), erythrocyte sedimentation rate (ESR), C‐reactive protein (CRP), and acute phase reactant proteins such as albumin are widely used as inflammatory markers. Several studies have investigated the efficacy of new parameters, for instance, neutrophil‐lymphocyte ratio (NLR), platelet‐lymphocyte ratio (PLR), and monocyte‐lymphocyte ratio (MLR) in determining the prognosis of different conditions including neurological, 9–14 vascular diseases, 15,16 diabetes, 17 and cancers 18 . Furthermore, it has been shown that NLR can be used as a prognostic factor in GBS 11–13,19 …”