Preoperative total lymphocyte count in peripheral blood as a predictor of poor outcome in adult cardiac surgery.

OBJECTIVE

The aim of this study was to investigate the prognostic value of the preoperative total lymphocyte count in peripheral blood as a predictor of postoperative complications and mortality in cardiac surgery.

DESIGN

A retrospective, observational study.

SETTING

The Novosibirsk State Research Institute of Circulation Pathology (single institution).

PARTICIPANTS

All adults undergoing primary cardiopulmonary bypass in 2009.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

The cohort size was 1,368 patients operated upon with cardiopulmonary bypass. Patient characteristics, hospital mortality, postoperative complications, ventilation time, intensive care unit, and hospital stay were analyzed. A preoperative total lymphocyte count <1,500 cells/μL was associated with significantly higher mortality by univariate (p < 0.0001) and multivariate (p < 0.044) analyses. A low preoperative total lymphocyte count was associated with more frequent inotropic support (p < 0.001); postoperative heart arrhythmia (p < 0.001); dialysis-dependent acute renal failure (p < 0.001); and a prolonged ventilation time (p = 0.001), intensive care unit stay (p < 0.001), and hospital stay (p = 0.007).

CONCLUSIONS

A low preoperative total lymphocyte count in peripheral blood is a useful prognostic criterion for the evaluation of a complicated postoperative period in cardiac patients operated under cardiopulmonary bypass.