Department of Anesthesiology, No. 1 People's Hospital of Pinghu, Jiaxing, Zhejiang, China (mainland).
Department of Anesthesiology, Jinhua Municipal Central Hospital, Jinhua, Zhejiang, China (mainland).
Med Sci Monit. 2021 Sep 27;27:e932954. doi: 10.12659/MSM.932954.
BACKGROUND Cardiopulmonary bypass (CPB) contributes to the development of systemic inflammatory response after cardiothoracic surgery. As a measure of inflammation and immune reaction, the neutrophil-to-lymphocyte ratio (NLR) has been linked to poor outcomes in a variety of diseases. However, it remains to be seen whether postoperative NLR is associated with CPB patient mortality. The purpose of this research was to explore the prognostic role of the postoperative NLR in adult patients undergoing cardiothoracic surgery with cardiopulmonary bypass. MATERIAL AND METHODS This is an analysis of data stored in the databases of the MIMIC-III, which contains data of critically ill patients for over 50,000. The exposure of interest was postoperative NLR. The primary outcomeaThis study incorporates data from the MIMIC III database, which includes more than 50 000 critically ill patients. The variable of interest was postoperative NLR. The primary outcome was 30-day mortality and the secondary outcomes were 90-day mortality, length of intensive care unit stay, and length of hospital stay. was 30-day mortality, the secondary outcome was 90-day mortality, length of hospital stay and length of ICU stay. RESULTS We enrolled 575 CPB patients. The ROC curve for the postoperative NLR to estimate mortality was 0.741 (95% confidence interval [CI]: 0.636-0.847, P<0.001), and the critical value was 7.48. There was a significant difference between different postoperative NLR levels in the Kaplan-Meier curve (P=0.045). Furthermore, elevated postoperative NLR was associated with increased hospital mortality (hazard ratio [HR]: 1.1, 95% CI: 1.0-1.1, P=0.021). However, there was no important relationship in these patients between the postoperative NLR levels and 90-day mortality (HR: 1.1, 95% CI: 1.0-1.5, P=0.465). CONCLUSIONS Our findings suggest that higher postoperative NLR is associated with greater hospital mortality in adult patients undergoing cardiopulmonary bypass surgery.
体外循环（CPB）会导致心胸外科手术后全身炎症反应。中性粒细胞与淋巴细胞比值（NLR）作为炎症和免疫反应的一种衡量标准，与多种疾病的不良预后相关。然而，CPB 患者术后 NLR 是否与死亡率相关仍有待观察。本研究旨在探讨 CPB 术后 NLR 与成人心胸外科手术患者的相关性。
这是对 MIMIC-III 数据库中存储的数据进行的分析，其中包含了超过 50000 名危重症患者的数据。感兴趣的暴露因素是术后 NLR。主要结局是 30 天死亡率，次要结局是 90 天死亡率、重症监护病房住院时间和住院时间。
我们纳入了 575 名 CPB 患者。术后 NLR 预测死亡率的 ROC 曲线为 0.741（95%置信区间[CI]：0.636-0.847，P<0.001），临界值为 7.48。在 Kaplan-Meier 曲线中，不同术后 NLR 水平之间存在显著差异（P=0.045）。此外，升高的术后 NLR 与住院死亡率增加相关（风险比[HR]：1.1，95%CI：1.0-1.1，P=0.021）。然而，在这些患者中，术后 NLR 水平与 90 天死亡率之间没有重要关系（HR：1.1，95%CI：1.0-1.5，P=0.465）。
我们的研究结果表明，CPB 术后 NLR 升高与成人 CPB 术后患者的住院死亡率增加相关。
