Abanoz Mustafa, Engin Mesut
Department of Cardiovascular Surgery, University of Health Sciences, Şanlıurfa Mehmet Akif Inan Training and Research Hospital, Şanlıurfa, Turkey.
Department of Cardiovascular Surgery, University of Health Sciences, Bursa Yüksek Ihtisas Training and Research Hospital, Bursa, Turkey.
Turk Gogus Kalp Damar Cerrahisi Derg. 2021 Jan 13;29(1):36-44. doi: 10.5606/tgkdc.dergisi.2021.20873. eCollection 2021 Jan.
In this study, we aimed to investigate the role of postcardiotomy neutrophil, lymphocyte, and platelet counts in predicting major adverse events after coronary artery bypass grafting.
A total of 373 patients (257 males, 116 females; median age 63, range 33 to 85 years) who underwent isolated coronary artery bypass grafting under cardiopulmonary bypass between January 2015 and January 2020 were retrospectively analyzed. The patients who did not develop any postoperative major adverse event were included in Group 1, while those who did constituted Group 2. Preoperative neutrophil-to-lymphocyte ratio, postcardiotomy neutrophil-to-lymphocyte ratio, postoperative Day 1 neutrophil-to-lymphocyte ratio, and neutrophil-to-lymphocyte x platelet ratio were calculated.
Preoperative neutrophil counts, C-reactive protein values, neutrophilto- lymphocyte ratio, total perfusion time, and length of intensive care unit and hospital stay were significantly higher in Group 2 (p=0.019, p=0.028, p<0.001, p=0.027, p<0.001, and p<0.001, respectively). Post-cardiotomy neutrophil, neutrophil-to-lymphocyte ratio, and neutrophil-to-lymphocyte x platelet ratio, along with the postoperative first day white blood cell count, neutrophil, C-reactive protein, neutrophil-to-lymphocyte ratio, and neutrophil-to-lymphocyte x platelet ratio were significantly higher in Group 2 (p=0.004, p<0.001, p<0.001, p=0.019, p=0.003, p=0.001, p<0.001, and p=0.041, respectively). The post-cardiotomy platelet and lymphocyte counts and postoperative first day lymphocyte counts were significantly lower in Group 2 (p<0.001, p=0.007, and p=0.009, respectively).
Post-cardiotomy neutrophil-to-lymphocyte ratio and neutrophilto- lymphocyte x platelet ratio can be easily accessible, inexpensive complete blood count parameters and may be more valuable in predicting major adverse events in patients undergoing coronary artery bypass grafting.
在本研究中，我们旨在探讨心脏切开术后中性粒细胞、淋巴细胞和血小板计数在预测冠状动脉旁路移植术后主要不良事件中的作用。
回顾性分析了2015年1月至2020年1月期间在体外循环下接受单纯冠状动脉旁路移植术的373例患者（257例男性，116例女性；中位年龄63岁，范围33至85岁）。未发生任何术后主要不良事件的患者纳入第1组，发生不良事件的患者纳入第2组。计算术前中性粒细胞与淋巴细胞比值、心脏切开术后中性粒细胞与淋巴细胞比值、术后第1天中性粒细胞与淋巴细胞比值以及中性粒细胞与淋巴细胞×血小板比值。
第2组患者的术前中性粒细胞计数、C反应蛋白值、中性粒细胞与淋巴细胞比值、总灌注时间以及重症监护病房和住院时间显著更高（分别为p = 0.019、p = 0.028、p < 0.001、p = 0.027、p < 0.001和p < 0.001）。第2组患者的心脏切开术后中性粒细胞、中性粒细胞与淋巴细胞比值以及中性粒细胞与淋巴细胞×血小板比值，连同术后第1天的白细胞计数、中性粒细胞、C反应蛋白、中性粒细胞与淋巴细胞比值以及中性粒细胞与淋巴细胞×血小板比值均显著更高（分别为p = 0.004、p < 0.001、p < 0.001、p = 0.019、p = 0.003、p = 0.001、p < 0.001和p = 0.041）。第2组患者的心脏切开术后血小板和淋巴细胞计数以及术后第1天的淋巴细胞计数显著更低（分别为p < 0.001、p = 0.007和p = 0.009）。
心脏切开术后中性粒细胞与淋巴细胞比值以及中性粒细胞与淋巴细胞×血小板比值是易于获取、成本低廉的全血细胞计数参数，在预测冠状动脉旁路移植术患者的主要不良事件中可能更具价值。
