Preoperative total lymphocyte count in peripheral blood as a predictor of poor outcome in adult cardiac surgery

J Cardiothorac Vasc Anesth. 2011 Dec;25(6):975-80. doi: 10.1053/j.jvca.2010.12.006. Epub 2011 Feb 26.

Abstract

Objective: The aim of this study was to investigate the prognostic value of the preoperative total lymphocyte count in peripheral blood as a predictor of postoperative complications and mortality in cardiac surgery.

Design: A retrospective, observational study.

Setting: The Novosibirsk State Research Institute of Circulation Pathology (single institution).

Participants: All adults undergoing primary cardiopulmonary bypass in 2009.

Interventions: None.

Measurements and main results: The cohort size was 1,368 patients operated upon with cardiopulmonary bypass. Patient characteristics, hospital mortality, postoperative complications, ventilation time, intensive care unit, and hospital stay were analyzed. A preoperative total lymphocyte count <1,500 cells/μL was associated with significantly higher mortality by univariate (p < 0.0001) and multivariate (p < 0.044) analyses. A low preoperative total lymphocyte count was associated with more frequent inotropic support (p < 0.001); postoperative heart arrhythmia (p < 0.001); dialysis-dependent acute renal failure (p < 0.001); and a prolonged ventilation time (p = 0.001), intensive care unit stay (p < 0.001), and hospital stay (p = 0.007).

Conclusions: A low preoperative total lymphocyte count in peripheral blood is a useful prognostic criterion for the evaluation of a complicated postoperative period in cardiac patients operated under cardiopulmonary bypass.

MeSH terms

  • Aged
  • Area Under Curve
  • Arrhythmias, Cardiac / epidemiology
  • Arrhythmias, Cardiac / etiology
  • Cardiac Surgical Procedures* / adverse effects
  • Cardiac Surgical Procedures* / mortality
  • Cardiopulmonary Bypass
  • Cardiotonic Agents / therapeutic use
  • Cohort Studies
  • Confidence Intervals
  • Critical Care / statistics & numerical data
  • Female
  • Humans
  • Infections / epidemiology
  • Liver Failure, Acute / epidemiology
  • Liver Failure, Acute / etiology
  • Lymphocyte Count*
  • Male
  • Middle Aged
  • Patient Readmission / statistics & numerical data
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / etiology
  • Postoperative Hemorrhage / epidemiology
  • Predictive Value of Tests
  • Preoperative Period
  • Prognosis
  • ROC Curve
  • Renal Dialysis
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Cardiotonic Agents