Dynamic Change of Lymphocyte-to-Monocyte Is Associated With the Occurrence of POCD After Cardiovascular Surgery: A Prospective Observational Study
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Published on: October 17, 2017
Qi Zhao1, Rui Gao1, Changliang Liu1
1Department of Anesthesiology and Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, China.
Insights
The lymphocyte-to-monocyte ratio (LMR) can predict postoperative cognitive dysfunction (POCD) after cardiovascular surgery. Higher preoperative LMR levels and dynamic changes indicate a greater risk of developing POCD.
Area of Science:
- Cardiology
- Neurology
- Immunology
Background:
- Postoperative cognitive dysfunction (POCD) is a significant complication following cardiovascular surgery.
- The lymphocyte-to-monocyte ratio (LMR) is linked to inflammatory conditions but its role in POCD is unclear.
Purpose of the Study:
- To investigate the predictive value of LMR for POCD in patients undergoing cardiovascular surgery.
- To assess the association between preoperative LMR levels and POCD occurrence.
Main Methods:
- Prospective observational study involving 75 patients undergoing cardiovascular surgery with cardiopulmonary bypass.
- Preoperative leukocyte counts were used to calculate LMR; neurocognitive functions were assessed pre- and post-surgery.
Main Results:
- 34 patients developed POCD. Preoperative LMR was higher in the POCD group (cutoff 4.855).
- Dynamic changes in LMR during the perioperative period were also significantly higher in the POCD group (cutoff 2.255).
Conclusions:
- Dynamic changes in peripheral blood LMR are associated with POCD development.
- Preoperative LMR serves as a potential prognostic biomarker for predicting POCD after cardiovascular surgery.
Abstract:
Objective: Postoperative cognitive dysfunction (POCD) is a common and severe complication of cardiovascular surgery. Lymphocyte-to-monocyte ratio (LMR) has been reported to be an independent predictor of lots of diseases associated with inflammation, but the association between the LMR and POCD is not clear. The present study aimed to investigate the potential value of LMR level to predict POCD in patients undergoing cardiovascular surgery. Methods: A prospective observational study was performed on the patients diagnosed with heart diseases undergoing cardiovascular surgeries with cardiopulmonary bypass. The leukocyte counts were measured by blood routine examination preoperatively. Then we calculated the LMR by dividing the lymphocyte count by the monocyte count. Neurocognitive functions were assessed 1 day before and 7 days after surgery. Perioperative factors were recorded to explore the relationship between LMR and POCD. Results: In total, 75 patients finished the whole study, while 34 patients developed POCD. The preoperative LMR level in the POCD group was higher than that in the non-POCD group. A cutoff value of 4.855 was identified to predict POCD occurrence according to ROC curve. The perioperative dynamic change of LMR level in the POCD group was higher than those in the non-POCD group. A cutoff value of 2.255 was identified to predict POCD occurrence according to ROC curve and the dynamic LMR change had similar varying trend with preoperative LMR level. Conclusions: The dynamic change of LMR level in the peripheral blood is associated with occurrence of POCD, and preoperative LMR level seems to be a prognostic biomarker of postoperative cognitive dysfunction in patients after cardiovascular surgery.
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