Pre-operative neutrophil-lymphocyte ratio predicts low cardiac output in children after cardiac surgery
Neutrophil-lymphocyte ratio has been associated with clinical outcomes in several groups of cardiac patients, including patients with coronary artery disease, cardiac failure, and cardiac transplant recipients. We hypothesised that pre- and/or post-operative haematological cell counts are associated...
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| Veröffentlicht in: | Cardiology in the young 2020-04, Vol.30 (4), p.521-525 |
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| creator | Iliopoulos, Ilias Alder, Matthew N Cooper, David S Villarreal, Enrique G Loomba, Rohit Sahay, Rashmi D Fei, Lin Steele, Paul E Flores, Saul |
| description | Neutrophil-lymphocyte ratio has been associated with clinical outcomes in several groups of cardiac patients, including patients with coronary artery disease, cardiac failure, and cardiac transplant recipients. We hypothesised that pre- and/or post-operative haematological cell counts are associated with clinical outcomes in children undergoing cardiac surgery for CHD. We performed a post hoc analysis of data collected as part of a prospective observational cohort study (n = 83, data available n = 47) of children evaluated for glucocorticoid receptor levels after cardiac surgery (July 2015-January 2016). The association of neutrophil-lymphocyte ratio with low cardiac output syndrome, time to inotrope free, and vasoactive-inotropic score was examined using proportional odds analysis, cox regression, and linear regression models, respectively. A majority (80%) of patients were infants (median/interquartile range 4.1/0.2-7.6 months) with conotruncal (36%) and left-sided obstructed lesions (28%). Two patients required mechanical circulatory support and three died. Higher pre-operative neutrophil-lymphocyte ratio was associated with higher cumulative odds of severe/moderate versus mild low cardiac output on post-operative day 1 (odds ratio 2.86; 95% confidence interval 1.18-6.93; p = 0.02). Pre-operative neutrophil-lymphocyte ratio was not significantly associated with time to inotrope free or vasoactive-inotrope score. Post-operative neutrophil-lymphocyte ratio was also not associated with outcomes. In children after congenital heart surgery, higher pre-operative neutrophil-lymphocyte ratio was associated with a higher chance of low cardiac output in the early post-operative period. Pre-operative neutrophil-lymphocyte ratio maybe a useful prognostic marker in children undergoing congenital heart surgery. |
| doi_str_mv | 10.1017/S1047951120000487 |
| format | Article |
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We hypothesised that pre- and/or post-operative haematological cell counts are associated with clinical outcomes in children undergoing cardiac surgery for CHD. We performed a post hoc analysis of data collected as part of a prospective observational cohort study (n = 83, data available n = 47) of children evaluated for glucocorticoid receptor levels after cardiac surgery (July 2015-January 2016). The association of neutrophil-lymphocyte ratio with low cardiac output syndrome, time to inotrope free, and vasoactive-inotropic score was examined using proportional odds analysis, cox regression, and linear regression models, respectively. A majority (80%) of patients were infants (median/interquartile range 4.1/0.2-7.6 months) with conotruncal (36%) and left-sided obstructed lesions (28%). Two patients required mechanical circulatory support and three died. Higher pre-operative neutrophil-lymphocyte ratio was associated with higher cumulative odds of severe/moderate versus mild low cardiac output on post-operative day 1 (odds ratio 2.86; 95% confidence interval 1.18-6.93; p = 0.02). Pre-operative neutrophil-lymphocyte ratio was not significantly associated with time to inotrope free or vasoactive-inotrope score. Post-operative neutrophil-lymphocyte ratio was also not associated with outcomes. In children after congenital heart surgery, higher pre-operative neutrophil-lymphocyte ratio was associated with a higher chance of low cardiac output in the early post-operative period. Pre-operative neutrophil-lymphocyte ratio maybe a useful prognostic marker in children undergoing congenital heart surgery.</description><identifier>ISSN: 1047-9511</identifier><identifier>EISSN: 1467-1107</identifier><identifier>DOI: 10.1017/S1047951120000487</identifier><identifier>PMID: 32131918</identifier><language>eng</language><publisher>England: Cambridge University Press</publisher><subject>Adolescent ; Cardiac output ; Cardiac Output - physiology ; Cardiac Output, Low - physiopathology ; Cardiac Output, Low - surgery ; Cardiac Surgical Procedures - methods ; Cardiovascular disease ; Child ; Child, Preschool ; Children ; Confidence intervals ; Congenital diseases ; Coronary artery ; Coronary artery disease ; Estimates ; Extracorporeal membrane oxygenation ; Female ; Follow-Up Studies ; Glucocorticoids ; Heart surgery ; Heart transplantation ; Humans ; Infant ; Inflammation ; Leukocyte Count ; Leukocytes (neutrophilic) ; Lymphocytes ; Lymphocytes - cytology ; Male ; Mortality ; Neutrophils ; Neutrophils - cytology ; Patients ; Postoperative Period ; Preoperative Period ; Prognosis ; Prospective Studies ; Regression analysis ; Regression models ; Statistical analysis ; Surgery ; Vasoactive agents</subject><ispartof>Cardiology in the young, 2020-04, Vol.30 (4), p.521-525</ispartof><rights>The Author(s), 2020. Published by Cambridge University Press</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c296t-d863ca8241b9917e10a9fb4924b4b3caa4f9ee04441da616504ea952ee95515a3</citedby><cites>FETCH-LOGICAL-c296t-d863ca8241b9917e10a9fb4924b4b3caa4f9ee04441da616504ea952ee95515a3</cites><orcidid>0000-0002-9116-2835 ; 0000-0001-8993-5192</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32131918$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Iliopoulos, Ilias</creatorcontrib><creatorcontrib>Alder, Matthew N</creatorcontrib><creatorcontrib>Cooper, David S</creatorcontrib><creatorcontrib>Villarreal, Enrique G</creatorcontrib><creatorcontrib>Loomba, Rohit</creatorcontrib><creatorcontrib>Sahay, Rashmi D</creatorcontrib><creatorcontrib>Fei, Lin</creatorcontrib><creatorcontrib>Steele, Paul E</creatorcontrib><creatorcontrib>Flores, Saul</creatorcontrib><title>Pre-operative neutrophil-lymphocyte ratio predicts low cardiac output in children after cardiac surgery</title><title>Cardiology in the young</title><addtitle>Cardiol Young</addtitle><description>Neutrophil-lymphocyte ratio has been associated with clinical outcomes in several groups of cardiac patients, including patients with coronary artery disease, cardiac failure, and cardiac transplant recipients. We hypothesised that pre- and/or post-operative haematological cell counts are associated with clinical outcomes in children undergoing cardiac surgery for CHD. We performed a post hoc analysis of data collected as part of a prospective observational cohort study (n = 83, data available n = 47) of children evaluated for glucocorticoid receptor levels after cardiac surgery (July 2015-January 2016). The association of neutrophil-lymphocyte ratio with low cardiac output syndrome, time to inotrope free, and vasoactive-inotropic score was examined using proportional odds analysis, cox regression, and linear regression models, respectively. A majority (80%) of patients were infants (median/interquartile range 4.1/0.2-7.6 months) with conotruncal (36%) and left-sided obstructed lesions (28%). Two patients required mechanical circulatory support and three died. Higher pre-operative neutrophil-lymphocyte ratio was associated with higher cumulative odds of severe/moderate versus mild low cardiac output on post-operative day 1 (odds ratio 2.86; 95% confidence interval 1.18-6.93; p = 0.02). Pre-operative neutrophil-lymphocyte ratio was not significantly associated with time to inotrope free or vasoactive-inotrope score. Post-operative neutrophil-lymphocyte ratio was also not associated with outcomes. In children after congenital heart surgery, higher pre-operative neutrophil-lymphocyte ratio was associated with a higher chance of low cardiac output in the early post-operative period. Pre-operative neutrophil-lymphocyte ratio maybe a useful prognostic marker in children undergoing congenital heart surgery.</description><subject>Adolescent</subject><subject>Cardiac output</subject><subject>Cardiac Output - physiology</subject><subject>Cardiac Output, Low - physiopathology</subject><subject>Cardiac Output, Low - surgery</subject><subject>Cardiac Surgical Procedures - methods</subject><subject>Cardiovascular disease</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Children</subject><subject>Confidence intervals</subject><subject>Congenital diseases</subject><subject>Coronary artery</subject><subject>Coronary artery disease</subject><subject>Estimates</subject><subject>Extracorporeal membrane oxygenation</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Glucocorticoids</subject><subject>Heart surgery</subject><subject>Heart transplantation</subject><subject>Humans</subject><subject>Infant</subject><subject>Inflammation</subject><subject>Leukocyte Count</subject><subject>Leukocytes (neutrophilic)</subject><subject>Lymphocytes</subject><subject>Lymphocytes - cytology</subject><subject>Male</subject><subject>Mortality</subject><subject>Neutrophils</subject><subject>Neutrophils - cytology</subject><subject>Patients</subject><subject>Postoperative Period</subject><subject>Preoperative Period</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Regression analysis</subject><subject>Regression models</subject><subject>Statistical analysis</subject><subject>Surgery</subject><subject>Vasoactive agents</subject><issn>1047-9511</issn><issn>1467-1107</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNplkFFLwzAUhYMobk5_gC8S8Lma26ZN8yjDqTBQUJ9Lmt5uHV1Tk1Tpvzdjcy_el3vhO-dcOIRcA7sDBuL-HRgXMgWIWRieixMyBZ6JCICJ03AHHO34hFw4t2EMkgTYOZkkMSQgIZ-S1ZvFyPRolW--kXY4eGv6ddNG7bjt10aPHukOGtpbrBrtHW3ND9XKVo3S1Ay-HzxtOqqDqbLYUVV7tEeBG-wK7XhJzmrVOrw67Bn5XDx-zJ-j5evTy_xhGelYZj6q8izRKo85lFKCQGBK1iWXMS95GYjitURknHOoVAZZyjgqmcaIMk0hVcmM3O5ze2u-BnS-2JjBduFlEadCZCLPOQsq2Ku0Nc5ZrIveNltlxwJYsau2-Fdt8Nwckodyi9XR8ddl8guh13Tg</recordid><startdate>20200401</startdate><enddate>20200401</enddate><creator>Iliopoulos, Ilias</creator><creator>Alder, Matthew N</creator><creator>Cooper, David S</creator><creator>Villarreal, Enrique G</creator><creator>Loomba, Rohit</creator><creator>Sahay, Rashmi D</creator><creator>Fei, Lin</creator><creator>Steele, Paul E</creator><creator>Flores, Saul</creator><general>Cambridge University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M7Z</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><orcidid>https://orcid.org/0000-0002-9116-2835</orcidid><orcidid>https://orcid.org/0000-0001-8993-5192</orcidid></search><sort><creationdate>20200401</creationdate><title>Pre-operative neutrophil-lymphocyte ratio predicts low cardiac output in children after cardiac surgery</title><author>Iliopoulos, Ilias ; 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We hypothesised that pre- and/or post-operative haematological cell counts are associated with clinical outcomes in children undergoing cardiac surgery for CHD. We performed a post hoc analysis of data collected as part of a prospective observational cohort study (n = 83, data available n = 47) of children evaluated for glucocorticoid receptor levels after cardiac surgery (July 2015-January 2016). The association of neutrophil-lymphocyte ratio with low cardiac output syndrome, time to inotrope free, and vasoactive-inotropic score was examined using proportional odds analysis, cox regression, and linear regression models, respectively. A majority (80%) of patients were infants (median/interquartile range 4.1/0.2-7.6 months) with conotruncal (36%) and left-sided obstructed lesions (28%). Two patients required mechanical circulatory support and three died. Higher pre-operative neutrophil-lymphocyte ratio was associated with higher cumulative odds of severe/moderate versus mild low cardiac output on post-operative day 1 (odds ratio 2.86; 95% confidence interval 1.18-6.93; p = 0.02). Pre-operative neutrophil-lymphocyte ratio was not significantly associated with time to inotrope free or vasoactive-inotrope score. Post-operative neutrophil-lymphocyte ratio was also not associated with outcomes. In children after congenital heart surgery, higher pre-operative neutrophil-lymphocyte ratio was associated with a higher chance of low cardiac output in the early post-operative period. Pre-operative neutrophil-lymphocyte ratio maybe a useful prognostic marker in children undergoing congenital heart surgery.</abstract><cop>England</cop><pub>Cambridge University Press</pub><pmid>32131918</pmid><doi>10.1017/S1047951120000487</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0002-9116-2835</orcidid><orcidid>https://orcid.org/0000-0001-8993-5192</orcidid></addata></record> |
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| subjects | Adolescent Cardiac output Cardiac Output - physiology Cardiac Output, Low - physiopathology Cardiac Output, Low - surgery Cardiac Surgical Procedures - methods Cardiovascular disease Child Child, Preschool Children Confidence intervals Congenital diseases Coronary artery Coronary artery disease Estimates Extracorporeal membrane oxygenation Female Follow-Up Studies Glucocorticoids Heart surgery Heart transplantation Humans Infant Inflammation Leukocyte Count Leukocytes (neutrophilic) Lymphocytes Lymphocytes - cytology Male Mortality Neutrophils Neutrophils - cytology Patients Postoperative Period Preoperative Period Prognosis Prospective Studies Regression analysis Regression models Statistical analysis Surgery Vasoactive agents |
| title | Pre-operative neutrophil-lymphocyte ratio predicts low cardiac output in children after cardiac surgery |
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