Neutrophil/lymphocyte ratio as a mortality predictor following coronary artery bypass graft surgery

Abstract

Bu çalışmada yeni geliştirilen bir enflamatuvar parametre olan nötrofil/lenfosit oranının koroner arter baypas greft (KABG) cerrahisi sonrası erken dönem mortalite prediktörü olarak etkisi araştırıldı. Ça lış mapla nı:Aralık 2011-Nisan 2012 tarihleri arasında kliniğimizde izole KABG cerrahisi yapılan ardışık 210 hasta prospektif olarak incelendi. Hastaların başlangıç özellikleri ve ameliyat öncesi nötrofil/lenfosit oranları belirlendi. Ameliyat sonrası takip süresi 86.1±38.9 gün idi. Primer sonlanım noktası, tüm-nedenlere bağlı mortalite olarak belirlendi. Bul gu lar: Dört hastada ameliyat sonrası ilk 30 günde olmak üzere, toplam sekiz hastada (%3.8) mortalite görüldü. Tek değişkenli analizlerde ameliyat öncesi nötrofil/lenfosit oranı, mortalite gelişen ve gelişmeyen gruplar arasında anlamlı derecede farklı olarak saptandı (p= 0.037). Alıcı işlem karakteristikleri (ROC) eğrisinde nötrofil/lenfosit oranı için eşik değeri 2.81 olarak belirlendi (AUC= 0.72, duyarlılık: %75, özgüllük: %67). İki grup arasında anlamlı farka sahip olan değişkenler ile yapılan lojistik regresyon analizinde ise, nötrofil/lenfosit oranı için eşik değerinin üzerinde olması mortalite için bağımsız bir prediktör olarak saptandı (OR 6.47, %95 CI 1.18-35.38, p= 0.031). So nuç: Kolay bir şekilde hesaplanabilen nötrofil/lenfosit oranı KABG cerrahisi sonrası erken dönem mortaliteyi öngörmede bağımsız bir faktör olarak kullanılabilir. Anah tar söz cük ler: Koroner arter baypas greftleme; lenfosit; mortalite; nötrofil. Background: In this study, we aimed to investigate the newly introduced inflammatory biomarker, neutrophil/ lymphocyte ratio, as a mortality predictor following coronary artery bypass graft (CABG) surgery. Methods: Between December 2011 and April 2012, 210 consecutive patients who underwent isolated CABG surgery in our clinic were prospectively analyzed. The baseline characteristics of the patients and preoperative neutrophil/ lymphocyte ratio were determined. The postoperative follow-up was 86.1±38.9 days. The primary endpoint was all-cause mortality. Results: Eight patients (3.8%) died of whom four deaths occurred during the first 30 days of follow-up. Univariate analyses revealed a significant difference in the preoperative neutrophil/lymphocyte ratio between the groups in which mortality was seen and the group in which no mortality was observed (p=0.037). The Receiver operating characteristic (ROC) curve showed a threshold value of 2.81 for neutrophil/lymphocyte ratio (AUC=0.72, sensitivity: 75%, specificity: 67%). Logistic regression analysis of the variables with significant differences between two groups revealed that the neutrophil/lymphocyte ratio over its threshold value was an independent predictor for mortality (OR 6.47, 95% CI 1.18-35.38, p=0.031). Conclusion: Neutrophil/lymphocyte ratio, which can be easily calculated, can be used as an independent factor in predicting early mortality following CABG surgery.

Does preoperative neutrophil-lymphocyte ratio indicate postoperative morbidity after repair of tetralogy of Fallot?

“…[1,2] The pNLR has been investigated in cardiovascular diseases in search of a powerful predictor of outcome. [3][4][5][6][7][8] However, as the pNLR has not been extensively evaluated in cyanotic pediatric cardiac surgery cases, we investigated whether the pNLR could predict postoperative morbidity in TOF in whom complete repair was performed.…”

“…The independent predictability of pNLR for the long-term mortality among CABG patients was also discussed and pNLR was found to be directly proportional with mortality. While the five-year mortality in cases with pNLR <2.3 was 8%, 2.3-3.4 was 13% and pNLR ≥3.5 was 20%, [14] Ünal et al [7] calculated a cut-off value of 2.81 for prediction of mortality.…”

“…[1,2] Recently, preoperative neutrophil-lymphocyte ratio (pNLR) which has been suggested as an indicator of inflammatory status has come into view in cardiovascular diseases as a powerful predictor of outcome. [3][4][5][6][7][8] To the best of our knowledge, although pNLR has been suggested as a valuable predictor of mortality in adults. [3][4][5][6][7] the literature is scarce in regard to the predictive value of pNLR on morbidity in a cyanotic pediatric cardiac surgery cohort.…”

“…[3][4][5][6][7][8] To the best of our knowledge, although pNLR has been suggested as a valuable predictor of mortality in adults. [3][4][5][6][7] the literature is scarce in regard to the predictive value of pNLR on morbidity in a cyanotic pediatric cardiac surgery cohort. Therefore, in this study, we aimed to investigate the impact of preoperative pNLR on postoperative morbidity after the complete repair of tetralogy of Fallot (TOF).…”

L-Carnitine Supplementation Reduces Short-Term Neutrophil-Lymphocyte Ratio in Patients Undergoing Coronary Artery Bypass Grafting

“…Therefore, a smaller value of the NLR may be diagnosed as a favorable pattern of systemic leukocytic alteration. 14 In a study designed byÜnal et al 15 , it was demonstrated that increased neutrophil/lymphocyte ratio can be accepted as an independent risk factor for early mortality after CABG surgery.…”