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Lymphocyte Levels and Morbidity and Mortality in Cardiovascular Surgery With Cardiopulmonary Bypass
Renata Costa Café de Castro1, Paula Natividade Costa1, Eduardo Augusto Victor Rocha2
1Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
Insights
A high number of postoperative lymphocytes indicates a poor prognosis in cardiovascular surgery. This finding confirms previous research and highlights a key indicator for patient outcomes after these complex procedures.
Area of Science:
- Cardiovascular Surgery
- Immunology
- Critical Care Medicine
Background:
- Previous research indicated a correlation between elevated postoperative lymphocytes and poor prognosis in cardiovascular surgery.
- This study expands on initial findings to validate the prognostic significance of lymphocyte count.
Purpose of the Study:
- To confirm the association between immediate postoperative lymphocyte count and prognosis in cardiovascular surgery patients.
- To identify key predictors of mortality, hospital stay, and intensive care unit stay.
Main Methods:
- Analysis of data from 338 consecutive patients undergoing cardiovascular surgery with cardiopulmonary bypass.
- Evaluation of 39 variables, including lymphocyte count, to determine their impact on patient outcomes.
Main Results:
- An immediate postoperative lymphocyte count exceeding 2175.0/mm³ was a significant indicator of poor prognosis (P<0.001).
- Several factors, including female sex, age, high EuroSCORE II, elevated creatinine, increased neutrophil/lymphocyte ratio, and surgical complications, were associated with mortality.
Conclusions:
- Elevated immediate postoperative lymphocyte count (> 2175.0/mm³) is a reliable indicator of poor prognosis in cardiovascular surgery patients.
- Lymphocyte count serves as a valuable prognostic marker in the context of cardiopulmonary bypass procedures.
Introduction:
A year ago, in a sample of 113 patients, our research group found that a high number of lymphocytes in the immediate postoperative period was correlated to a poor prognosis in cardiovascular surgeries. This study is an expansion of the initial study in order to confirm this finding.
Methods:
We analyzed the data of 338 consecutive patients submitted to cardiovascular surgeries with cardiopulmonary bypass performed at Hospital Universitário Ciências Médicas (Belo Horizonte/Brazil) from 2015 to 2017. We analyzed 39 variables with the outcomes death, hospital stay, and intensive care unit stay.
Results:
The value of lymphocytes in the immediate postoperative period > 2175.0/mm³ was an indicator of poor prognosis in this sample (P<0.001). The variables female sex, age, high level of European System for Cardiac Operative Risk Evaluation II, increased stay in the intensive care unit and in the ward, elevation of creatinine in the preoperative period and at intensive care unit discharge, elevation of the percentage of immediate postoperative period segmented neutrophils, high immediate postoperative period neutrophil/lymphocyte ratio, fasting hyperglycemia, preoperative critical condition, reintubation, mild or transient acute renal failure, surgical infection, cardiopulmonary bypass, and aortic cross-clamping and mechanical ventilation durations also had an impact on the mortality outcome.
Conclusion:
The value of lymphocytes in the immediate postoperative period > 2175.0/mm3 was an indicator of poor prognosis in cardiovascular surgery with cardiopulmonary bypass.
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