Preoperative Total Lymphocyte Count in Peripheral Blood as a Predictor of Poor Outcome in Adult Cardiac Surgery

Lomivorotov, Vladimir V.; Efremov, Sergey; Boboshko, Vladimir; Leyderman, I. N.; Cheung, Albert T.; Karaskov, Alexander

doi:10.1053/j.jvca.2010.12.006

Cited by 22 publications

(14 citation statements)

References 30 publications

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“…In the present study, dialysis-dependent ARF was developed significantly more often in patients with a PTLC < 1500 cells/µL than in patients with a PTLC > 1500 cells/µL. This result was along with, but more distinguished than other studies ( 11 , 44 ). There have been modifiable risk factors for sternal wound infection ( 45 , 46 ).…”

Section: Discussionsupporting

confidence: 65%

Significance of Preoperative Total Lymphocyte Count as a Prognostic Criterion in Adult Cardiac Surgery

et al. 2014

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Background:Evaluation of operational risk is a consequential goal in perioperative management of patients in cardiac surgery. Preoperative total lymphocyte count (PTLC) is a prognostic criterion of adverse major cardiovascular outcomes.Objectives:The purpose of this study was to investigate the prognostic value of PTLC as an independent predictor of postoperative morbidity and mortality in cardiac surgery.Patients and Methods:Of 1604 patients scheduled for cardiac surgery between September, 2012 and March, 2013, a total of 1171 consecutive patients underwent elective primary valvular heart surgery and coronary artery bypass grafting. The patients were divided to three groups according to their PTLCs. The baseline characteristics and postoperative mortality and morbidity of the patients as well as the intensive care unit (ICU) stay according to the PTLCs were recorded and analyzed. The only inclusion criterion was a preoperative complete blood count. Exclusion criteria included: ages under 18 or over 80 years old, emergency surgery, adult patients with congenital heart disease and previous open heart surgery, and patients with any bacterial or viral infection during two weeks before the surgery. Protocol of anesthetic medications was used in all the patients similarly and according to standard. All the patients were admitted to the ICU after the surgery.Results:A PTLC < 1500 cells/µL was associated with significantly high mortality and morbidity (P = 0.0001). In-hospital mortality and major composite morbidity were 9.65% and 28.4%, respectively. Low PTLC was associated with more frequent need for inotropic and intra-aortic balloon pump (IABP) support (P < 0.001), dialysis-dependent acute renal failure (P = 0.0001), postoperative superficial wound infections (P = 0.0001) and prolong ICU stay (P = 0.0001).Conclusions:Our study results showed that low PTLC was an independent, valuable prognostic criterion, with high sensitivity and specificity for evaluation of postoperative morbidity and mortality in cardiac surgery.

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Section: Discussionsupporting

confidence: 65%

Significance of Preoperative Total Lymphocyte Count as a Prognostic Criterion in Adult Cardiac Surgery

et al. 2014

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“…Systems using genetic polymorphisms for selected inflammatory and vasoconstrictor genes have shown a two- to fourfold improvement over clinical factors alone in explaining post-cardiac surgery AKI 37 . Preoperative factors including total lymphocyte count <1,500 cells/µL and elevated C-reactive protein have been shown to be associated with post-cardiac surgery AKI 38,39 . Preoperative factors related to the procedure itself increase the predictive power for patients undergoing noncardiac surgery 40 .…”

Section: Risk Factorsmentioning

confidence: 99%

Perioperative Acute Kidney Injury

Hobson

Ruchi

2017

Critical Care Clinics

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Synopsis Acute kidney injury (AKI) is a common complication in the surgical patient and is associated with increases in mortality, an increased risk for chronic kidney disease (CKD) and hemodialysis after discharge, and increased cost. Better understanding of the risk factors that contribute to perioperative AKI has led to improved AKI prediction and will eventually lead to improved prevention of AKI, mitigation of injury when AKI occurs and enhanced recovery in patients who sustain AKI. The development of advanced clinical prediction scores for AKI, new imaging techniques and novel biomarkers for early detection of AKI provides new tools toward these ends.

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“…Interindividual variations in the initial inflammatory response designated as postoperative complication vectors (32)(33)(34)(35)(36), could thus be a risk factor of postoperative infection. To date, no study evidenced clinical or biological factors that could strongly predict postoperative infectious complications (7)(8)(9)37,38). Other studies investigated the relationship between inflammation activation and the occurrence of secondary bacterial infections.…”

Section: Discussionmentioning

confidence: 99%

Immature Granulocytes: A Risk Factor of Infection after Cardiac Surgery

Daix

Guérin

Tavernier

et al. 2018

Cytometry Part B Clinical

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Background Similarly, to sepsis, cardiac surgery with cardiopulmonary bypass (CPB) induces major changes in leukocyte subsets. Immature granulocytes (IGs) increase both in sepsis and after open‐heart surgery. Secondary infections are a major complication of cardiac surgery with CPB. We hypothesized that the assessment of leukocyte subsets with multicolor flow cytometry (FCM) could help the front‐line clinician to better identify patients at high risk of infectious complications in this clinical setting. Methods In this single‐center observational pilot study, we identified 26 leukocyte subsets using three combinations of antibodies (from 5 to 10 colors per combinations): one devoted to granulocytes, one to lymphocyte subpopulations and one for rare cells (plasma cells and dendritic cells). Blood samples were obtained preoperatively and immediately after open‐heart surgery under CPB in 59 patients without immuno‐depression, chronic or neoplastic inflammatory disease, and immunosuppressive treatment. Secondary infections during hospital stay were recorded. Results Patients exhibited postoperative NK and T‐cell lymphopenia, increased levels of IGs and monocytes with low levels of surface HLA DR. Twelve patients developed secondary infectious complications. Only immediate postoperative IG levels were significantly higher in these patient (6.6 [6; 7.39] G/L vs. 3.8 [2.67; 5.72] G/L, P = 0.01). Patients with immediate postoperative increase of IGs developed more frequently infectious complication (10/22 [46%] vs. 2/37 [5%]: P < 0.001). Conclusions This study suggests that postoperative increase of IGs is related to postoperative organ failure and promises to help in early identification of patients at risk of infectious complications after open‐heart surgery under CPB. © 2018 International Clinical Cytometry Society

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Preoperative Total Lymphocyte Count in Peripheral Blood as a Predictor of Poor Outcome in Adult Cardiac Surgery

Cited by 22 publications

References 30 publications

Significance of Preoperative Total Lymphocyte Count as a Prognostic Criterion in Adult Cardiac Surgery

Significance of Preoperative Total Lymphocyte Count as a Prognostic Criterion in Adult Cardiac Surgery

Perioperative Acute Kidney Injury

Immature Granulocytes: A Risk Factor of Infection after Cardiac Surgery

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