Neutrophil-Lymphocyte Ratio: Prognostic Impact in Heart Surgery. Early Outcomes and Late Survival

Silberman, Shuli; Abu-Yunis, Ulfat; Tauber, Rachel; Shavit, Linda; Grenader, Tal; Fink, Daniel; Bitran, Daniel; Merin, Ofer

doi:10.1016/j.athoracsur.2017.07.033

Cited by 62 publications

(55 citation statements)

References 23 publications

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“…Preoperative biomarkers have been associated with worse outcomes in patients undergoing cardiac surgery. In the last decade, the preoperative NLR was introduced to cardiac surgery as a strong independent risk factor for adverse events . The value of preoperative biomarkers as a risk factor for adverse outcomes for a wide range of CHD or SV physiology is minimal .…”

Section: Discussionmentioning

confidence: 99%

“…Among several inflammatory biomarkers, the neutrophil‐lymphocyte ratio (NLR), defined as the ratio of absolute counts of neutrophils to lymphocytes, has emerged as a valid biomarker in the stratification and prognosis for adults with coronary artery disease undergoing coronary artery bypass grafting (CABG) and in patients undergoing valve surgery …”

Section: Introductionmentioning

confidence: 99%

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Prognostic value of the preoperative neutrophil‐lymphocyte ratio in patients undergoing the bidirectional Glenn procedure

et al. 2019

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Introduction:The neutrophil-lymphocyte ratio (NLR) has been associated with worse outcomes in patients undergoing coronary artery bypass graft surgery. Little is known about this association in the pediatric population who require surgery for congenital heart defects, especially in patients with a single ventricle (SV).Objective: To analyze the association of the preoperative NLR with outcomes in patients undergoing the bidirectional Glenn procedure.Methods: This study involved a retrospective cohort analysis of 141 consecutive patients with SV undergoing the bidirectional Glenn procedure between January 2011 and December 2017 in two centers. The preoperative NLR was included in the last hemogram test before surgery. According to the NLR level, the patients were divided into group I (NLR < 1), group II (NLR between 1 and 2), and group III (NLR > 2).The primary endpoint was total hospital length of stay (LOS), and secondary endpoints were mechanical ventilation (MV) time, intensive care unit (ICU) LOS, ventricular dysfunction, complications, and middle-term mortality.Results: The average follow-up duration was 48 months. There were 61, 47, and 33 patients in groups I, II, and III, respectively. Patients in group III exhibited an increased risk of prolonged total hospital LOS (P = .00). An increase in MV time (P = .03) and ICU LOS (P = .02) was also observed in this group, and these patients experienced greater mortality in 24 months following the surgery (P = .03). There was no association between the NLR and ventricular dysfunction (P = .26) and complications (P = .46). Conclusion:A high preoperative NLR was associated with worse outcomes in patients with SV physiology undergoing the bidirectional Glenn procedure. K E Y W O R D Sbidirectional Glenn procedure, congenital heart disease, neutrophil-lymphocyte ratio, single-ventricle physiology

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prognostic value of the preoperative neutrophil‐lymphocyte ratio in patients undergoing the bidirectional Glenn procedure

et al. 2019

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“…In a study that evaluated long-term mortality, it was shown that increased NLR means increased short-term complications and increased long-term mortality. This study also recommended adding the NLR to the charts of risk scoring before cardiac surgery (13). A broadly based metaanalysis revealed that the increase of NLR after surgery may predict the risk of new-onset atrial fibrillation (14).…”

Section: Discussionmentioning

confidence: 99%

The effect of neutrophil-lymphocyte ratio on the postoperative course of coronary artery bypass graft surgery

Özer¹,

Mardin²,

Kılıç³

et al. 2018

Turk J Med Sci

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Background/aim: Recovery after coronary artery bypass graft surgery (CABG) can be complicated, leading to postoperative morbidity. The roles of hematologic and surgery-related parameters are important. The main purpose of this study is to determine the role of preoperative and postcardiopulmonary bypass neutrophil/lymphocyte ratio (NLR) on postoperative recovery. Materials and methods: Sixty-two patients aged between 41 and 80 years, scheduled for elective CABG surgery with ASA I-II risk and without a history of preoperative blood transfusion, were included in the study. Three patients were excluded due to their need for additional surgical procedures other than CABG. The patients were divided into two groups that were formed depending on preoperative NLR cutoff values below (Group 1, n = 37) and above 4 (Group 2, n = 22). Postoperative data such as length of stay in the hospital and in the intensive care unit (ICU), chest tube drainage, and incidence of atrial fibrillation were recorded for all patients. Results: Preoperative NLR was significantly lower in Group 1 (P < 0.0001), and there was no significant difference between the groups in terms of postoperative NLR (P = 0.217) when the two groups were compared. The patients in Group 2 had a longer length of stay in the ICU (P = 0.035) and in the hospital (P = 0.034). There was a positive correlation between preoperative NLR and length of stay in the ICU (P = 0.017) and the hospital (P = 0.014). No statistically significant differences in postoperative drainage or incidence of postoperative atrial fibrillation were detected between the two groups. Conclusion: The results of our study demonstrate that the postoperative NLR may be useful to predict the length of hospital and ICU stays and help the management of follow-up and treatment processes in patients undergoing CABG surgery.

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“…An elevated neutrophil/lymphocyte ratio is reportedly to be correlated with the incidence of SSI after posterior lumbar instrumentation surgery [18] and cardiac surgery [19], while the perioperative neutrophil-lymphocyte ratio is correlated with survival in patients undergoing colorectal cancer surgery [20] and higher mortality in patients with breast and kidney cancer [21]. In the present study, consistent with the lack of difference between survivors and non-survivors in the number of preoperative treatments involving neoadjuvant chemotherapy and radiation (Table 1), there were no difference between survivors and non-survivors in the neutrophil/lymphocyte ratio before the start of surgery or after the end of surgery (Table 2).…”

Section: Discussionmentioning

confidence: 99%

Perioperative Patient Factors Related to 2-Year Outcome after Esophageal Cancer Surgery: A Retrospective Cohort Study

Hasegawa-Moriyama¹,

Kanmura²

2020

OJAnes

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Background: Surgical treatment for esophageal cancer is major invasive surgery. Recently, opioids have been implicated in the promotion of cancer recurrence and metastasis because of their immunosuppressive effects. However, it has not been fully evaluated whether the intraoperative use of opioids is directly correlated with postoperative prognosis in the clinical setting. Therefore, this study aimed to identify perioperative factors related to postoperative complications and 2-year survival in patients undergoing esophageal cancer surgery. Methods: We retrospectively reviewed 105 patients who underwent surgery for esophageal cancer at Kagoshima University Hospital from January 2013 to December 2017. Patient parameters were compared between survivors and non-survivors for 2 years after surgery. Results: The 2-year survival rate after esophageal cancer surgery was 76.2% (80 survivors vs. 25 non-survivors). The incidence of postoperative pneumonia within 7 days after surgery was significantly higher in non-survivors compared with survivors (36.0% vs. 16.3%; odds ratio, 2.90; 95% confidence interval, 1.06-7.96, P < 0.05). Pneumonia was associated with postoperative metastasis (odds ratio, 3.00; 95% confidence interval, 1.117-8.072, P = 0.029). The intraoperative dosage of opioids calculated as fentanyl equivalents was not correlated with any postoperative complications or 2-year survival. The preoperative albumin level and neutrophil-lymphocyte ratio were associated with the incidence of postoperative pneumonia. Conclusions: Postoperative pneumonia may be a possible predictor of 2-year prognosis in patients after esophageal cancer surgery, and is not correlated with intraoperative use of opioids. Preoperative physical status including immune and nutrient states may be more important for postoperative prognosis after esophageal cancer surgery.

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Neutrophil-Lymphocyte Ratio: Prognostic Impact in Heart Surgery. Early Outcomes and Late Survival

Cited by 62 publications

References 23 publications

Prognostic value of the preoperative neutrophil‐lymphocyte ratio in patients undergoing the bidirectional Glenn procedure

Prognostic value of the preoperative neutrophil‐lymphocyte ratio in patients undergoing the bidirectional Glenn procedure

The effect of neutrophil-lymphocyte ratio on the postoperative course of coronary artery bypass graft surgery

Perioperative Patient Factors Related to 2-Year Outcome after Esophageal Cancer Surgery: A Retrospective Cohort Study

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