Prognostic Value of the Leuko-Glycaemic Index in the Postoperative Period of Coronary Artery Bypass Grafting

Seoane, Leonardo; Burgos, Lucrecia María; Espinoza, Juan; Furmento, Juan; Benzadón, Mariano; Vrancic, Mariano; Piccinini, Fernando; Navia, Daniel

doi:10.21470/1678-9741-2020-0349

Cited by 5 publications

(10 citation statements)

References 22 publications

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“…This is corroborated by the findings of Seoane et al . [ 4 ] that demonstrate such a prognostic value of LGI in patients undergoing CABG surgery. However, Seoane et al .…”

Section: Discussionmentioning

confidence: 98%

“…On ICU admission, LGI was computed by dividing the product of serum glucose and TLC by 1000 and expressed in mg/dL.mm 3 . [ 4 ] The maximum serum lactate values within the 72-hour post-operative period was recorded from the arterial blood gas analysis. Low cardiac output syndrome (LCOS) was defined as CI <2.0 L/min/m 2 with systolic blood pressure <90 mmHg, in conjunction with signs of tissue hypo-perfusion in the absence of hypovolemia.…”

Section: Methodsmentioning

confidence: 99%

“…Specific to post-cardiac surgical outcomes, the product of immediate post-operative total leucocyte count (TLC) and serum glucose level or the leucoglycemic index (LGI) has recently been associated with an accentuated risk of post-operative mortality by Seoane et al . [ 4 ] Albeit noteworthy from a prognostic perspective, the Seoane e t al . analysis was limited by the lack of account for the concurrent post-operative vasopressor-inotropic requirements.…”

Section: Introductionmentioning

confidence: 99%

“…analysis was limited by the lack of account for the concurrent post-operative vasopressor-inotropic requirements. [ 4 ] This becomes more relevant amid their proposition of an elevated LGI as a harbinger of peri-operative inflammation alongside the comprehension that inflammation in turn predisposes post-operative patients to heightened vasopressor-inotropic requirements (owing to inflammatory myocardial depression and/or vascular hypo-responsiveness). [ 5 6 ]…”

Section: Introductionmentioning

confidence: 99%

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Leucoglycemic index predicts post-operative vasopressor-inotropic requirement after adult cardiac surgery (LEUCOGLYPTICS): A retrospective single-center study

Magoon,

Singh,

Kashav

et al. 2024

Journal of Anaesthesiology Clinical Pharmacology

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Background and Aims: Cardiac surgery often necessitates considerable post-operative vasoactive-inotropic support. Given an encouraging literature on the prognostic potential of leucoglycemic index (LGI) [serum glucose (mg/dl) × total leucocytes count (cells/mm3)/1000], we aimed to evaluate whether intensive care unit (ICU)-admission LGI can predict post-operative vasopressor-inotropic requirements following cardiac surgery on cardio-pulmonary bypass (CPB). Material and Methods: The data of patients undergoing cardiac surgery at our tertiary care center between January 2015 and December 2020 was retrospectively reviewed. The vasopressor-inotropic requirement was estimated using the VIS (vasoactive-inotropic score) values over the first post-operative 72 hrs. Subsequently, VISi (indexed VIS) was computed as maxVIS[0-24hrs] + maxVIS[24-48hrs] +2 × maxVIS[48-72hrs]/10), and the study participants were divided into h-VISi (VISi ≥3) and l-VISi (VISi <3). Results: Out of 2138 patients, 479 (22.40%) patients categorized as h-VISi. On univariate analysis: LGI, age, European System for Cardiac Operative Risk Evaluation score (EuroSCORE II), left-ventricle ejection fraction, prior congestive heart failure (CHF), chronic renal failure, angiotensin-converting enzyme inhibitors, combined surgeries, CPB and aortic cross-clamp (ACC) duration, blood transfusion, and immediate post-operative glucose were significant h-VISi predictors. Subsequent to multi-variate analysis, the predictive performance of LGI (OR: 1.09; 95% CI: 1.03–1.14; P = 0.002) prior CHF (OR: 2.35; 95% CI: 1.44–3.82; P = 0.001), CPB time (OR: 1.08; 95% CI: 1.02–1.14; P = 0.019), ACC time (OR: 1.03; 95% CI: 1.02–1.04; P = 0.008), and EuroSCORE II (OR: 1.14; 95% CI: 1.06–1.21; P < 0.001) remained significant. With 1484.75 emerging as the h-VISi predictive cut-off, patients with LGI ≥ 1484.75 also had a higher incidence of vasoplegia, low-cardiac output syndrome, new-onset atrial fibrillation, acute kidney injury, and mortality. LGI additionally exhibited a significant positive correlation with duration of mechanical ventilation and ICU stay (R = 0.495 and 0.564, P value < 0.001). Conclusion: An elevated LGI of greater than 1484.75 independently predicted a VISindex ≥3 following adult cardiac surgery on CPB.

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“…This is corroborated by the findings of Seoane et al . [ 4 ] that demonstrate such a prognostic value of LGI in patients undergoing CABG surgery. However, Seoane et al .…”

Section: Discussionmentioning

confidence: 98%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Leucoglycemic index predicts post-operative vasopressor-inotropic requirement after adult cardiac surgery (LEUCOGLYPTICS): A retrospective single-center study

Magoon,

Singh,

Kashav

et al. 2024

Journal of Anaesthesiology Clinical Pharmacology

View full text Add to dashboard Cite

show abstract

“…Furthermore, high levels of C-Reactive Protein have been identified as a biomarker of AKI or mortality in several clinical settings [15,16]. In addition, leukocyte count is related to AKI in patients who underwent isolated coronary artery bypass grafting with cardiopulmonary bypass [17] and neutrophil count has been described as a marker of AKI in different diseases [18][19][20][21][22][23]. In line with this, the need to use different thresholds depending on the presence/absence of renal failure has been addressed in the case of PCT in postoperative infection.…”

Section: Introductionmentioning

confidence: 99%

Influence of Renal Dysfunction on the Differential Behaviour of Procalcitonin for the Diagnosis of Postoperative Infection in Cardiac Surgery

Varga-Martínez

Martín-Fernández

Heredia-Rodríguez

et al. 2022

JCM

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Background: procalcitonin is a valuable marker in the diagnosis of bacterial infections; however, the impairment of renal function can influence its diagnostic precision. The objective of this study is to evaluate the differential behaviour of procalcitonin, as well as its usefulness in the diagnosis of postoperative pulmonary infection after cardiac surgery, depending on the presence or absence of impaired renal function. Materials and methods: A total of 805 adult patients undergoing cardiac surgery with extracorporeal circulation (CBP) were prospectively recruited, comparing the behaviour of biomarkers between the groups with and without postoperative pneumonia and according to the presence or absence of renal dysfunction. Results: Pulmonary infection was diagnosed in 42 patients (5.21%). In total, 228 patients (28.32%) presented postoperative renal dysfunction. Procalcitonin was significantly higher in infected patients, even in the presence of renal dysfunction. The optimal procalcitonin threshold differed markedly in patients with renal dysfunction compared to patients without renal dysfunction (1 vs. 0.78 ng/mL p < 0.05). The diagnostic accuracy of procalcitonin increased significantly when the procalcitonin threshold was adapted to renal function. Conclusions: Procalcitonin is an accurate marker of postoperative infection in cardiac surgery, even in the presence of renal dysfunction. Renal function is an important determinant of procalcitonin levels and, therefore, its diagnostic thresholds must be adapted in the presence of renal dysfunction.

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Prognostic value of leukocyte-glycemic index in long-term evolution of diabetic patients with peripheral arterial disease following endovascular treatment

Mureșan,

Arbănași,

Bartus

et al. 2024

Acta Marisiensis - Seria Medica

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Objective: The aim of this article is to determine the predictive value of the leukocyte-glycemic index in the long-term evolution of diabetic patients with peripheral arterial disease following endovascular treatment. Methods: This retrospective observational study enrolled 127 diabetic patients diagnosed with peripheral arterial disease requiring endovascular treatment. Patients were categorized into two groups based on the severity of the infrapopliteal atherosclerotic lesions identified during the pre-operative Computer Tomography Angiography examination. Group 1 includes patients without severe damage to the infrapopliteal artery, while Group 2 includes patients with severe infrapopliteal artery damage, identified by stenosis greater than 70% on all infrapopliteal arteries. The primary outcome was to assess the association between leukocyte-glycemic index value at baseline and the severity of infrapopliteal atherosclerotic lesions and long-term major amputation after percutaneous transluminal angioplasty. Results: Patients in Group 2 had a higher incidence of cardiovascular events (p=0.009), stage IV Leriche-Fontaine (p=0.016), and incidence of major amputation (p<0.001), as well as an increased value of leukocyte-glycemic index (p=0.004). During the follow-up, patients with above-median leukocyte-glycemic index value have a higher risk of major amputation (p=0.034), as seen in the Kaplan-Meier analysis. Moreover, at cox-regression, elevated biomarker values were associated with long-term risk of major amputation, independent of age, sex, cardiovascular risk factors, and below-the-knee arterial occlusion (HR:2.69, p=0.001). Conclusions: Elevated values of leukocyte-glycemic index are associated with the severity of infrapopliteal atherosclerotic lesions and major amputation in the long term.

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Prognostic Value of the Leuko-Glycaemic Index in the Postoperative Period of Coronary Artery Bypass Grafting

Cited by 5 publications

References 22 publications

Leucoglycemic index predicts post-operative vasopressor-inotropic requirement after adult cardiac surgery (LEUCOGLYPTICS): A retrospective single-center study

Leucoglycemic index predicts post-operative vasopressor-inotropic requirement after adult cardiac surgery (LEUCOGLYPTICS): A retrospective single-center study

Influence of Renal Dysfunction on the Differential Behaviour of Procalcitonin for the Diagnosis of Postoperative Infection in Cardiac Surgery

Prognostic value of leukocyte-glycemic index in long-term evolution of diabetic patients with peripheral arterial disease following endovascular treatment

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