Department of Cardiovascular Surgery, Derince Research and Training Hospital, Kocaeli, Turkey.
Department of Cardiovascular Surgery, Kocaeli University Medical Faculty, Kocaeli, Turkey.
Braz J Cardiovasc Surg. 2021 Jun 1;36(3):354-364. doi: 10.21470/1678-9741-2020-0163.
This study investigated the role of the neutrophil-lymphocyte ratio (NLR), the perioperative changes in NLR (delta-NLR), the platelet-lymphocyte ratio (PLR), and the platelet count in predicting acute kidney injury (AKI) following coronary artery bypass grafting (CABG) during hospital stay.
The records of 396 patients with preoperative creatinine < 1.5 mg/dl undergoing isolated CABG between October 2015 and October 2019 were reviewed retrospectively. Diagnosis of AKI was based on the Kidney Disease Improving Global Outcomes definition. Demographic data, operative data, in-hospital mortality, preoperative NLR, PLR, and platelet counts were compared between patients with (AKI group) and without (non-AKI group) postoperative AKI. Additionally, NLR, delta-NLR, and PLR values were calculated daily for the first four postoperative days. A "subsequent AKI group" was formed for the first four postoperative days by excluding patients diagnosed with AKI. The daily and overall predictivity of the markers for AKI are investigated.
AKI was present in 86 patients during the postoperative period, while 310 patients had normal postoperative renal functions. NLR, delta-NLR, and PLR on the first four postoperative days (P<0.001 for all) were significantly associated with the development of AKI in subsequent days. Multivariate analysis identified postoperative NLR (odds ratio 1.17, 95% confidence interval 1.11-1.23; P<0.001) as an independent predictor of AKI. PLR lost its significant association with AKI at the values measured at discharge from hospital (P>0.05).
NLR values measured on the first four days postoperatively are a useful tool in predicting AKI during hospital stay following CABG.
本研究旨在探讨中性粒细胞与淋巴细胞比值（NLR）、围手术期 NLR 变化（delta-NLR）、血小板与淋巴细胞比值（PLR）和血小板计数在预测冠状动脉旁路移植术（CABG）住院期间急性肾损伤（AKI）中的作用。
回顾性分析了 2015 年 10 月至 2019 年 10 月期间 396 例术前肌酐<1.5mg/dl 的患者的病历。AKI 的诊断依据是改善全球肾脏病预后组织的定义。比较术后发生 AKI（AKI 组）与未发生 AKI（非 AKI 组）患者的人口统计学数据、手术数据、住院死亡率、术前 NLR、PLR 和血小板计数。此外，还计算了术后前 4 天的 NLR、delta-NLR 和 PLR 值。术后前 4 天排除诊断为 AKI 的患者，形成“后续 AKI 组”。研究了标志物对 AKI 的每日和整体预测能力。
术后有 86 例患者发生 AKI，310 例患者术后肾功能正常。术后前 4 天的 NLR、delta-NLR 和 PLR（均 P<0.001）与随后几天 AKI 的发生显著相关。多变量分析确定术后 NLR（优势比 1.17，95%置信区间 1.11-1.23；P<0.001）是 AKI 的独立预测因子。PLR 在出院时的测量值与 AKI 失去显著相关性（P>0.05）。
术后前 4 天测量的 NLR 值是预测 CABG 住院期间 AKI 的有用工具。
