Abstract
BackgroundWe aimed to explore the relationship between the neutrophil to lymphocyte ratio (NLR) and the early clinical outcomes in children with congenital heart disease (CHD) associated with pulmonary arterial hypertension (PAH) after cardiac surgery.MethodsA retrospective observational study involving 190 children from January 2013 to August 2019 was conducted. Perioperative clinical and biochemical data were collected.ResultsWe found that pre-operative NLR was significantly correlated with AST, STB, CR and UA (P < 0.05), while post-operative NLR was significantly correlated with ALT, AST, BUN (P < 0.05). Increased post-operative neutrophil count and NLR as well as decreased lymphocyte count could be observed after cardiac surgery (P < 0.05). Level of pre-operative NLR was significantly correlated with mechanical ventilation time, ICU stay time and total length of stay (P < 0.05), while level of post-operative NLR was only significantly correlated to the first two (P < 0.05). By using ROC curve analysis, relevant areas under the curve for predicting prolonged mechanical ventilation time beyond 24 h, 48 h and 72 h by NLR were statistically significant (P < 0.05).ConclusionFor patients with CHD-PAH, NLR was closely related to early post-operative complications and clinical outcomes, and could act as a novel marker to predict the occurrence of prolonged mechanical ventilation.
Highlights
We aimed to explore the relationship between the neutrophil to lymphocyte ratio (NLR) and the early clinical outcomes in children with congenital heart disease (CHD) associated with pulmonary arterial hypertension (PAH) after cardiac surgery
It is reported that the systemic inflammatory response syndrome after cardiopulmonary bypass (CPB) in children resulted in prolonged mechanical ventilation time, intensive care unit (ICU) stay time as well as total hospitalization duration [1]
Xu et al found that post-operative NLR in pediatric patients with CHD after CPB was significantly higher than those before operation, which was consistent with increased mechanical ventilation time and intensive care unit (ICU) stay time [8]
Summary
We aimed to explore the relationship between the neutrophil to lymphocyte ratio (NLR) and the early clinical outcomes in children with congenital heart disease (CHD) associated with pulmonary arterial hypertension (PAH) after cardiac surgery. For patients with CHD, it is of great significance to explore effective clinical indicators in the early stage after CPB cardiac surgery to evaluate the level of inflammatory response. A variety of studies have shown that inflammatory markers are closely related to the clinical outcomes of many cardiovascular diseases [2,3,4]. Recent studies perceived that the higher pre-operative NLR in children with CHD was associated with a higher risk for low cardiac output in the early post-operative period and correlated with mortality [5,6,7]. Xu et al found that post-operative NLR in pediatric patients with CHD after CPB was significantly higher than those before operation, which was consistent with increased mechanical ventilation time and intensive care unit (ICU) stay time [8]
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