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Published on: March 27, 2018
Effects of Preoperative WBC Count on Post-CABG Surgery Clinical Outcome
Alexander Aizenshtein1, Erez Kachel1, Grosman Rimon Liza1
1From the Azrieli Faculty of Medicine in the Galilee, Bar Ilan University, and the Department of Cardiac Surgery and Cardiovascular Medicine, Baruch Padeh Medical Center, Tiberias, Israel.
Insights
Preoperative white blood cell (WBC) count impacts outcomes after coronary artery bypass graft (CABG) surgery. Higher WBC counts correlate with longer hospital stays, emphasizing the need for careful patient assessment.
Area of Science:
- Cardiovascular Surgery
- Hematology
- Clinical Outcomes Research
Background:
- White blood cells (WBCs) are key mediators of inflammation and influence vascular health.
- Elevated preoperative WBC counts are linked to increased cardiovascular complications and mortality post-coronary artery bypass graft (CABG) surgery.
Purpose of the Study:
- To investigate the association between preoperative WBC count and clinical outcomes following CABG surgery.
- To determine if WBC count predicts postoperative complications such as atrial fibrillation, prolonged hospital stay, readmission, and mortality.
Main Methods:
- Retrospective analysis of 239 patients undergoing CABG surgery.
- Statistical analysis to evaluate the correlation between preoperative WBC count and various postoperative clinical outcomes.
Main Results:
- Higher preoperative WBC counts were significantly associated with longer hospitalization (B = 0.392, P < 0.01).
- A WBC count exceeding 8150/μL predicted extended hospital stays (Z = 2.090, P = 0.03).
- Low lymphocyte counts correlated with atrial fibrillation (B = -0.543, P = 0.03), and female patients showed higher rates of postoperative atrial fibrillation and readmission.
Conclusions:
- Preoperative WBC count is a potential predictor of postoperative clinical outcomes in CABG patients.
- Surgeons should consider preoperative WBC count and patient sex in surgical planning and postoperative management strategies.
Objective:
White blood cells (WBCs) play a major role in inflammation, with effects on the vascular wall, the microvascular blood flow, and endothelial cells and endothelial function. Previous studies have shown that a high WBC count may increase the risk of cardiovascular complication rate and mortality after coronary artery bypass graft (CABG) surgery. The aim of the study was to evaluate the association between preoperative WBC count and the post-CABG clinical outcome.
Methods:
A retrospective study that was based on 239 patients who underwent CABG surgery in our medical center. Statistical analysis estimated the effect of WBC count in postoperative clinical outcomes, including atrial fibrillation, length of stay, readmission rate, and death.
Results:
The preoperative WBC count was associated with longer hospitalization length (B = 0.392, P < 0.01). A preoperative WBC count >8150/μL predicted a longer stay (Z = 2.090, P = 0.03). A low lymphocyte count was associated with atrial fibrillation (B = -0.543, P = 0.03). Female patients were older (Z = 2.920, P < 0.01), had impaired renal function (Z = -3.340, P < 0.01), and had a higher rate of postoperative atrial fibrillation (df 2 = 3.780, P = 0.05) and readmission (df 2 = 5.320, P = 0.02).
Conclusions:
Preoperative WBC count may have an effect on the postoperative clinical outcome in patients undergoing CABG. Surgeons should pay more attention to patients' WBC count and sex and plan surgery and postoperative management accordingly.
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