Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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The Neutrophil-to-Lymphocyte Ratio as a Predictor of Postoperative Outcomes in Patients Undergoing Coronary Artery Bypass Grafting

  • Hyun Ah Lim (Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Joon Kyu Kang (Department of Thoracic and Cardiovascular Surgery, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Hwan Wook Kim (Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Hyun Son (Department of Thoracic and Cardiovascular Surgery, Uijeongbu Eulji University Medical Center) ;
  • Ju Yong Lim (Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea)
  • Received : 2022.08.16
  • Accepted : 2022.12.22
  • Published : 2023.03.05
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Abstract

Background: The neutrophil-to-lymphocyte ratio (NLR) has been suggested as a novel predictive marker of cardiovascular disease. However, its prognostic role in patients under-going coronary artery bypass grafting (CABG) is unclear. This study aimed to determine the association between the preoperative NLR and early mortality in patients undergoing CABG. Methods: Cardiac surgery was performed in 2,504 patients at Seoul St. Mary's Hospital from January 2010 to December 2021. This study retrospectively reviewed 920 patients who underwent isolated CABG, excluding those for whom the preoperative NLR was unavailable. The primary endpoints were the 30- and 90-day mortality after isolated CABG. Risk factor analysis was performed using logistic regression analysis. Based on the optimal cut-off value of preoperative NLR on the receiver operating characteristic curve, high and low NLR groups were compared. Results: The 30- and 90-day mortality rates were 3.8% (n=35) and 7.0% (n=64), respectively. In the multivariable analysis, preoperative NLR was significantly associated with 30-day mortality (odds ratio [OR], 1.28; 95% confidence interval [CI], 1.17-1.39; p<0.001) and 90-day mortality (OR, 1.17; 95% CI, 1.07-1.28; p<0.001). The optimal cut-off value of the preoperative NLR was 3.4. Compared to the low NLR group (<3.4), the high NLR group (≥3.4) showed higher 30- and 90-day mortality rates (1.4% vs. 12.1%, p<0.001; 2.8% vs. 21.3%, p<0.001, respectively). Conclusion: Preoperative NLR was strongly associated with early mortality after isolated CABG, especially in patients with a high preoperative NLR (≥3.4). Further studies with larger cohorts are necessary to validate these results.

Keywords

References

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