The Relationship Between Neutrophil to Lymphocyte Ratio and Clinical Outcome in Pediatric Patients After Cardiopulmonary Bypass Surgery: A Retrospective Study.

Hao Xu,Yanxin Sun,Sibi Zhang

doi:10.3389/fped.2019.00308

Abstract

Background: The aim of this study was to investigate the prognostic role of the neutrophil to lymphocyte ratio (NLR) in pediatric patients undergoing open-heart surgery with cardiopulmonary bypass (CPB).Methods: A retrospective cohort study of 61 pediatric patients who underwent CPB in the First Affiliated Hospital of Nanjing Medical University from January 2017 to October 2018 was conducted. All perioperative clinical data, including neutrophil count, lymphocyte count, and C-reactive protein (CRP), were collected retrospectively. The prognostic value of NLR and its association with extubation time, duration of intensive care unit (ICU) stay and in-hospital stay were analyzed.Results: Neutrophil count, NLR, and CRP were significantly increased post-operative compared with pre-operative (p < 0.05). The increased post-operative levels of NLR were significantly associated with longer extubation time, as well as prolonged post-operative cardiac ICU stay (p < 0.05). Multivariate linear regression analysis revealed that elevated NLR displayed a significant independent association with extubation time and the duration of an ICU stay.Conclusion: Increased post-operative NLR followed by cardiac surgery with CPB in pediatric patients was associated with longer extubation time and a longer duration of an ICU stay.

Highlights

Previous studies have demonstrated that a systemic inflammatory response is activated in patients undergoing cardiothoracic surgery with cardiopulmonary bypass (CBP) [1, 2]
Increased perioperative neutrophil to lymphocyte ratio (NLR) was shown to be associated with poor cardiac surgery patient outcomes in adult patients [8, 9]
NLR has not been well-studied in exclusively pediatric patients undergoing cardiac surgery requiring cardiopulmonary bypass (CPB)

Summary

Introduction

Previous studies have demonstrated that a systemic inflammatory response is activated in patients undergoing cardiothoracic surgery with cardiopulmonary bypass (CBP) [1, 2]. Multiple studies have demonstrated a relationship between altered production of inflammatory mediators and clinical outcome in pediatric patients after CPB [3, 4]. NLR has not been well-studied in exclusively pediatric patients undergoing cardiac surgery requiring CPB. The objective of the present study is to examine the association between NLR levels and clinical outcomes in pediatric patients undergoing cardiac surgery with CPB. The aim of this study was to investigate the prognostic role of the neutrophil to lymphocyte ratio (NLR) in pediatric patients undergoing open-heart surgery with cardiopulmonary bypass (CPB)

Objectives

Methods

Results

Conclusion