Association of Preoperative Cell Counts With Outcomes After Operation for Congenital Heart Disease

Abstract

In children undergoing CHD operation, preoperative lymphopenia is associated with increased in-hospital mortality postoperatively. Preoperative lymphopenia, neutrophilia, and thrombocytopenia are associated with longer postoperative LOS and with development of postoperative complications. Preoperative cell counts may serve as important prognostic markers in preoperative planning for patients with CHD.

Preoperative cell line abnormalities in children with chronic cardiac disease: Symbol or surrogate?

“…Several studies have examined cell line abnormalities as predictors of morbidity and mortality in children and adults with cardiac disease or those undergoing cardiac surgery 2‐10 . Among the most commonly studied abnormalities were thrombocytopenia, lymphopenia, and neutrophilia.…”

“…Lymphopenia has been identified as an indicator for higher mortality and longer recovery after pediatric cardiac surgery 2‐4 . However, a cause‐effect relationship between lymphopenia and worse outcomes has not been clearly elucidated.…”

“…Moreover, neutrophilia has been identified as an indicator for higher complications, longer recovery, and increased need of mechanical circulatory support after pediatric cardiac surgery 2,4 . A cause‐effect relationship between neutrophilia and worse outcomes might be more explicable here as neutrophilia is part of the systemic immune response to the stress related to cardiac illness or surgery.…”

“…1 Several studies have examined cell line abnormalities as predictors of morbidity and mortality in children and adults with cardiac disease or those undergoing cardiac surgery. [2][3][4][5][6][7][8][9][10] Among the most commonly studied abnormalities were thrombocytopenia, lymphopenia, and neutrophilia. In their current study, Manuel et al 1 focused on NLR and the higher ratio (NLR>2) is likely the product of both neutrophilia and lymphopenia.…”

“…Lymphopenia has been identified as an indicator for higher mortality and longer recovery after pediatric cardiac surgery. [2][3][4] However, a cause-effect relationship between lymphopenia and worse outcomes has not been clearly elucidated. On the other hand, lymphopenia has been commonly demonstrated in children and adults with chronic heart disease, presumably as a result to increased cortisol and catecholamine levels from the prolonged stress response associated with these long-lasting cardiac illnesses.…”