Predictive value of neutrophil to lymphocyte ratio on acute kidney injury after on-pump coronary artery bypass: a retrospective, single-center study

General Thoracic and Cardiovascular Surgery - 2022
Guangqing Zhang1, Cheng Lü2, Fei Ling3, Zheng Jianshe1, Guang Zeng1, Yan Zhu1, Jianjun Chen1, Ming Tian4, Hao Chen1, Wei Liu1
1Department of Cardiothoracic Macrovascular Surgery, Sinopharm Dongfeng General Hospital, Hubei University of Medicine, Shiyan, People’s Republic of China
2Department of Pulmonary and Critical Care Medicine, Hanchuan People’s Hospital, Xiaogan, People’s Republic of China
3School of Nursing, Hubei University of Medicine, Shiyan, People’s Republic of China
4Department of Nephrology, Wuhan Fourth Hospital, Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China

Tóm tắt

Abstract Objective To investigate the predictive value of preoperative neutrophil to lymphocyte ratio (NLR) on acute kidney injury (AKI) after on-pump coronary artery bypass (ONCAB). Methods Patients who underwent elective ONCAB for coronary heart disease were included. NLR was calculated according to the results of preoperative routine blood test, patients were divided into non-AKI and AKI groups, and the differences in clinical baseline data between the two groups were compared. Results A total of 154 patients were included in this study, including 57 (37%) with postoperative AKI and 97 (63%) without AKI. Compared with the patients in non-AKI group, those in AKI group had higher NLR (2.63 (1.83, 3.505) vs. 2.06 (1.7, 2.56), p = 0.002), higher serum creatinine (78 (67, 98.5) vs. 70.9 ± 16.8 umol/L, p < 0.001), longer cardiopulmonary bypass time, and longer aortic cross clamp time. After dividing patient into tertiles based on NLR, those with higher NLR had higher risk of postoperative AKI than those with lower NLR (30% vs. 25% vs. 55.8%, p for trend = 0.003). Patients in Tertile2 and Tertile3 had higher NLR compared to those in Tertile1 (p < 0.05); multivariate logistic regression analysis showed patients with elevated preoperative NLR and blood creatinine had higher risk of postoperative AKI. ROC curve showed that patients’ preoperative NLR combined with blood creatinine had better predictive value for postoperative AKI. Conclusion Elevated preoperative NLR is associated with AKI after ONCAB, and had prognostic utility independent of other recognized risk factors.

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Tài liệu tham khảo

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General Thoracic and Cardiovascular Surgery

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