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

Abstract

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.

Postoperative Neutrophil to Lymphocyte Ratio as an Overall Mortality Midterm Prognostic Factor following OPCAB Procedures

“…The results indicate that inflammatory processes occurring one day after the surgery have a significant negative impact on the patient’s survival. The postoperative NLR results were related to ICU stay and length of hospitalization in previous studies [ 10 ]. The correlation between the risk of MACCE following surgical revascularization in CPB was presented with a cut-off value of 4.32 in the multivariable analysis [ 11 ].…”

Learning Needs and Educational Strategies for Adult Patients in the Preoperative Period of Myocardial Revascularization: Scoping Review

“…Figure 3 presents the resources and educational strategies used divided into two categories: resources and strategies.  Educational booklet with texts and images (4,10,13,15,36,37,39)  Video with general information about the surgery, care, recovery, and patient experience (5,11,12,14,15,19,26,30,36,37)  Slide show (6,13)  Audio tape (13)  Educational leaflets (3,9,14,23,30,37)  Self-explanatory interactive software with text, videos, images, sounds, graphics, 3D animations on topics related to surgery and care (16)  Administration of a questionnaire after the educational session (30)  Brochure with illustrations (19)  Conventional education through verbal guidance and response to patient questions (3-6, 9, 11, 12, 14, 15, 17-20, 23-32, 34, 35, 37)  Preoperative education course (24)  Guided tour of the operating room (34,36)  Guided tour of the ICU (14,19,30,34,36)  Guided tour of the surgical unit (14,30,34)  Meeting with ICU staff and other patients…”

“… Coronary artery disease: Risk factors, causes, signs and symptoms, measures to minimize disease progression and treatment(3, 4, 6, 12-14, 16, 19-23, 31, 38)  Need and process of hospitalization -perioperative environment: Hospital characteristics, routines, team involved in care and surgical team, operating room(11,12,14,16,17,19,24,33)  Care before surgery in the hospital: Preoperative exams, preoperative fasting, shaving, medication to reduce anxiety and facilitate sleep the day before and one hour before (4, 13, 14,19, 22, 23, 28, 30, 38) Preoperative drugs(14,17,21,24,33,37)  Psychological counseling regarding anxiety, fear, waiting for surgery, anger, stress(12, 13, 21, 23, 24, 26, 28, 36)  Infection control (4)  Surgery names, how it is performed, goals, duration, cardiopulmonary bypass, complications, results, risks, prognosis, and survival rate (4, 6, 9, 11, 13, 14, 16, 17, 22-26, 30, 33, 36, 38, 39)  Anesthesia and post-anesthetic recovery (22, 30, 38)  Postoperative environment of the Intensive Care Unit -bedside, equipment, routine activities and length of stay in the ICU. Family support: Visiting guidelines, hand hygiene (4, 5, 11,13, 14, 17, 23-25, 30, 33) Invasive devices and other postoperative care: Urine catheters, drains, monitoring lines, venous  Postoperative nausea control(35)  Postoperative physical and pulmonary rehabilitation: Weaning from ventilation, breathing exercises, deep breathing, coughing, spirometer use, dyspnea control, walking, deambulation, mobility, active and passive exercises, physical activity(3,4,9,11,13,14,17,21,23,24, 26,27,30,33,35,37,38)  Postoperative nutrition and weight control(3,4,…”

The Significance of Simple Inflammatory Markers in Off Pump Surgery—Review

“…This novel approach based on preoperative hematological indices may enable us to explore why some of patients require repeated interventions or represent a worse prognosis group during follow-up despite successful surgical therapy as presented in Table 1 (Ref. [60,[68][69][70][71][72][73][74]).…”