Savluk Omer Faruk, Guzelmeric Fusun, Yavuz Yasemin, Ukil Fatma, Yilmaz Arif, Cevirme Deniz, Tuncer Eylem, Hatemi Ali Can, Ceyran Hakan
Kartal Kosuyolu High Education and Training Hospital, Denizer Str., Cevizli, Kartal, 34865, Istanbul, Turkey.
Gen Thorac Cardiovasc Surg. 2019 Aug;67(8):669-676. doi: 10.1007/s11748-019-01081-y. Epub 2019 Feb 21.
Hypoplastic left heart syndrome is a lethal congenital heart malformation when untreated resulting in a 95% mortality in the first month of life. In this study, we aimed to investigate the newly introduced inflammatory biomarker, neutrophil-lymphocyte ratio, as a mortality predictor in postoperative hypoplastic left heart syndrome patients.
Patients were divided into two groups; Group 1 consisted of 33 patients who were discharged and Group 2 including 20 patients who were deceased following surgery. Patients' preoperative demographic characteristics, total white blood cell counts, neutrophil counts, lymphocyte counts, neutrophil-lymphocyte ratio, C-reactive proteins, alanine aminotransferase, aspartate transaminase, urea, and creatinine levels were recorded. Studys' primary endpoint was all-cause patient mortality following surgery.
The preoperative neutrophil-lymphocyte ratio was found to be significantly different between the groups (p = 0.001). High neutrophil-lymphocyte ratio was found to be associated with an increased risk of death. The ROC curves of neutrophil-lymphocyte ratio were found to be associated with mortality. The area under curve for the preoperative neutrophil-lymphocyte ratio was 0.74. Neutrophil-lymphocyte ratio predicted mortality with a sensitivity of 78% and a specificity of 65%.
Neutrophil-lymphocyte ratio can contribute to the early identification of patients at high risk for complications. In addition, through the use of NLR, clinicians could implement measures for the optimal therapeutic approach of cardiac surgery patients and the elimination of adverse patient outcomes.
左心发育不全综合征是一种致命的先天性心脏畸形，未经治疗时会导致95%的患儿在出生后第一个月内死亡。在本研究中，我们旨在探讨新引入的炎症生物标志物中性粒细胞与淋巴细胞比值，作为左心发育不全综合征术后患者死亡率的预测指标。
将患者分为两组；第1组由33例出院患者组成，第2组包括20例术后死亡患者。记录患者术前的人口统计学特征、白细胞总数、中性粒细胞计数、淋巴细胞计数、中性粒细胞与淋巴细胞比值、C反应蛋白、丙氨酸转氨酶、天冬氨酸转氨酶、尿素和肌酐水平。本研究的主要终点是术后全因患者死亡率。
发现两组之间术前中性粒细胞与淋巴细胞比值存在显著差异（p = 0.001）。发现高中性粒细胞与淋巴细胞比值与死亡风险增加相关。中性粒细胞与淋巴细胞比值的ROC曲线与死亡率相关。术前中性粒细胞与淋巴细胞比值的曲线下面积为0.74。中性粒细胞与淋巴细胞比值预测死亡率的敏感度为78%，特异度为65%。
中性粒细胞与淋巴细胞比值有助于早期识别并发症高危患者。此外，通过使用中性粒细胞与淋巴细胞比值，临床医生可以为心脏手术患者实施最佳治疗方法的措施，并消除不良患者结局。
