Aizenshtein Alexander, Kachel Erez, Liza Grosman Rimon, Hijazi Basem, Blum Arnon
From the Azrieli Faculty of Medicine in the Galilee, Bar Ilan University, and the Department of Cardiac Surgery and Cardiovascular Medicine, Baruch Padeh Medical Center, Tiberias, Israel.
South Med J. 2020 Jun;113(6):305-310. doi: 10.14423/SMJ.0000000000001100.
White blood cells (WBCs) play a major role in inflammation, with effects on the vascular wall, the microvascular blood flow, and endothelial cells and endothelial function. Previous studies have shown that a high WBC count may increase the risk of cardiovascular complication rate and mortality after coronary artery bypass graft (CABG) surgery. The aim of the study was to evaluate the association between preoperative WBC count and the post-CABG clinical outcome.
A retrospective study that was based on 239 patients who underwent CABG surgery in our medical center. Statistical analysis estimated the effect of WBC count in postoperative clinical outcomes, including atrial fibrillation, length of stay, readmission rate, and death.
The preoperative WBC count was associated with longer hospitalization length (B = 0.392, < 0.01). A preoperative WBC count >8150/μL predicted a longer stay ( = 2.090, = 0.03). A low lymphocyte count was associated with atrial fibrillation (B = -0.543, = 0.03). Female patients were older ( = 2.920, < 0.01), had impaired renal function ( = -3.340, < 0.01), and had a higher rate of postoperative atrial fibrillation ( 2 = 3.780, = 0.05) and readmission ( 2 = 5.320, = 0.02).
Preoperative WBC count may have an effect on the postoperative clinical outcome in patients undergoing CABG. Surgeons should pay more attention to patients' WBC count and sex and plan surgery and postoperative management accordingly.
白细胞（WBC）在炎症反应中起主要作用，对血管壁、微血管血流、内皮细胞及内皮功能均有影响。既往研究表明，白细胞计数升高可能会增加冠状动脉搭桥术（CABG）后心血管并发症发生率及死亡率。本研究旨在评估术前白细胞计数与冠状动脉搭桥术后临床结局之间的关联。
一项基于在我院医疗中心接受冠状动脉搭桥手术的239例患者的回顾性研究。统计分析评估白细胞计数对术后临床结局的影响，包括房颤、住院时间、再入院率及死亡率。
术前白细胞计数与住院时间延长相关（B = 0.392，P < 0.01）。术前白细胞计数>8150/μL提示住院时间延长（β = 2.090，P = 0.03）。淋巴细胞计数低与房颤相关（B = -0.543，P = 0.03）。女性患者年龄较大（β = 2.920，P < 0.01），肾功能受损（β = -3.340，P < 0.01），术后房颤发生率较高（χ² = 3.780，P = 0.05）及再入院率较高（χ² = 5.320，P = 0.02）。
术前白细胞计数可能对接受冠状动脉搭桥术患者的术后临床结局有影响。外科医生应更加关注患者的白细胞计数及性别，并据此制定手术及术后管理方案。
