The role of the neutrophil–lymphocyte ratio for pre-operative risk stratification of acute kidney injury after tetralogy of Fallot repair

Manuel, Valdano; Miana, Leonardo Augusto; Turquetto, Aida Luiza Ribeiro; Guerreiro, Gustavo Pampolha; Fernandes, Natália; Jatene, Marcelo Biscegli

doi:10.1017/s1047951121001943

Cited by 10 publications

(17 citation statements)

References 24 publications

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“…In the current study, preoperative NLR was not an independent risk factor for predicting postoperative adverse outcomes, which was different from the conclusions of previous studies [ 8 , 27 , 29 ]. Although preoperative NLR was associated with mechanical ventilation time and length of ICU stay like other studies, the small coefficient indicated a weak correlation.…”

Section: Commentcontrasting

confidence: 99%

The association between neutrophil–lymphocyte ratio and poor outcomes following infant cardiac surgery

Gao

Liu

Wang

et al. 2021

BMC Cardiovasc Disord

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Background Neutrophil–lymphocyte ratio (NLR) is a valuable indicator for evaluating inflammation and adverse outcomes after cardiac surgery. The objective of this study was to evaluate the association of perioperative NLR with clinical outcomes in infants undergoing congenital heart surgery with cardiopulmonary bypass. Methods We performed a retrospective review of 424 consecutive infants (≤ 1 year) undergoing cardiac surgery between January 2019 and September 2019. Neonates (≤ 28 days) and patients with incomplete NLR data were excluded. The study endpoint was a composite of poor outcomes after surgery. We assess the correlation between perioperative NLR and clinical outcomes. A receiver operating characteristic curve and multivariable logistic regression were applied to identify the prognosis performance of postoperative NLR for poor outcomes. Results A total of 68 (16%) infants experienced at least one of the poor outcomes. Postoperative NLR on the third day after the surgery showed the best prognostic significance (AUC = 0.763, 95%CI 0.700–0.826) among perioperative period, with a cut-off value of 2.05. Postoperative NLR was also strongly correlated with mechanical ventilation time, length of ICU and hospital stay (p < 0.001). Multivariable logistic regression revealed that elevated postoperative NLR (OR 3.722, 95%CI 1.895–7.309, p < 0.001) was an independent risk factor for poor outcomes in infants after cardiac surgery. Conclusions Postoperative NLR was correlated with increased mechanical ventilation time, length of ICU and hospital stay. Elevated postoperative NLR was an independent predictor for poor outcomes after cardiac surgery in infants.

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Section: Commentcontrasting

confidence: 99%

The association between neutrophil–lymphocyte ratio and poor outcomes following infant cardiac surgery

Gao

Liu

Wang

et al. 2021

BMC Cardiovasc Disord

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“…Of 404 cyanosis patients (44.9%) in 6 studies, 24,26,27,29,31,33 210 patients underwent CHD repair and 194 patients underwent surgical palliation (Table 1). A total of 193 patients (50.2%) were noted to have TOF.…”

Section: Prognostic Value Of Nlr In Congenital Heart Surgerymentioning

confidence: 99%

“…29 Further evaluation of this group of patients demonstrated that a higher NLR was associated with grade III AKI ( P = .040). 33…”

Section: Prognostic Value Of Nlr In Congenital Heart Surgerymentioning

confidence: 99%

Neutrophil–Lymphocyte Ratio in Congenital Heart Surgery: What Is Known and What Is New?

Manuel

Miana

Jatene

2022

World J Pediatr Congenit Heart Surg

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Operative mortality after repair of congenital heart disease has improved dramatically over the past few decades. Nevertheless, there is always room for the additional mitigation of complications and mortality. Being able to anticipate adverse outcomes is clearly important, especially when using low-cost and easily accessible resources. The neutrophil–lymphocyte ratio (NLR) is defined as the ratio of the absolute neutrophil to lymphocyte count, which can be easily measured using a regular white blood cell count. Recently, preoperative NLR has been shown to be a predictor of outcomes in patients undergoing congenital heart surgery. Although it presented promising results, there are still many gaps to be filled like the normal value for children, the ideal cutoff value to predict adverse outcomes, the wide variation and its correlation with other biomarkers, and if it is a modifiable risk factor. The aim of this review is to understand the prognostic value of preoperative NLR as a biomarker predictor of outcomes in patients undergoing congenital heart surgery based on previous clinical studies and to propose future directions in order to solve the above-mentioned questions.

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“…29 As one of the most common components of the systemic inflammatory response, lymphocytes are well-known inflammatory markers involved in AKI. Increasing studies have taken the lymphocyte-based serum inflammatory biomarkers into consideration for the development of AKI and prognosis of patients in different populations, such as neutrophil-tolymphocyte ratio, 8,30,31 platelet-to-lymphocyte ratio, 32,33 prognostic nutritional index 34,35 and so on. However, limited data have focused on the combination of inflammatory factors and glucose metabolic factor.…”

Section: Dovepressmentioning

confidence: 99%

“…[1][2][3][4] Among them, cardiac surgery-associated AKI (CSA-AKI), as the second most common cause of AKI for ICU patients, is independently associated with increased morbidity and mortality, prolonged length of hospital stays and increased healthcare costs. [5][6][7][8] It is currently acknowledged that timely identifying patients at high risk of AKI and then providing appropriate interventions at an early stage could improve the prognosis of AKI patients. [9][10][11] Hence, a novel biomarker with high prediction accuracy and easily accessible is essential for clinicians in immediate and appropriate decision-making regarding treatment options.…”

Section: Introductionmentioning

confidence: 99%

Preoperative Glucose-to-Lymphocyte Ratio is an Independent Predictor for Acute Kidney Injury After Cardiac Surgery in Patients in Intensive Care Unit

Li¹,

Zou²

2021

IJGM

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Background:We aimed to investigate the association between preoperative glucose-tolymphocyte ratio (GLR) and cardiac surgery associated with acute kidney injury (CSA-AKI) in patients in the intensive care unit (ICU). Methods: The Medical Information Mart for Intensive Care IV (MIMIC-IV version 1.0) database was used to identify adults' patients who performed cardiac surgery during ICU stay. The primary outcome was the development of AKI based on the KDIGO criteria. Multivariable logistic regression was applied to investigate the association between GLR and clinical outcomes, and propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were also used to validate our findings. Results: The optimal cut-off value for GLR was 1.28. Among the 7181 patients who conducted cardiac surgery, 2072 high-GLR group (≥1.28) patients and 2072 low-GLR group (<1.28) patients, had similar propensity scores were included in this study. After matching, the high-GLR group had a significantly higher incidence of AKI (odds ratio, OR, 3.28, 95% confidence index, 95% CI, 2.81-3.84, P <0.001) even after adjustment for confounding factors. Moreover, the performance of GLR was superior to that of SOFA scores and GLR plus clinical model could add more net benefit for CSA-AKI than clinical model alone. Conclusion:Preoperative GLR could serve as a good predictor for CSA-AKI in patients in ICU.

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The role of the neutrophil–lymphocyte ratio for pre-operative risk stratification of acute kidney injury after tetralogy of Fallot repair

Cited by 10 publications

References 24 publications

The association between neutrophil–lymphocyte ratio and poor outcomes following infant cardiac surgery

The association between neutrophil–lymphocyte ratio and poor outcomes following infant cardiac surgery

Neutrophil–Lymphocyte Ratio in Congenital Heart Surgery: What Is Known and What Is New?

Preoperative Glucose-to-Lymphocyte Ratio is an Independent Predictor for Acute Kidney Injury After Cardiac Surgery in Patients in Intensive Care Unit

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