Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jul;18(3):284-289.
doi: 10.17085/apm.22244. Epub 2023 Jul 18.

A new hematologic predictor of major adverse events after cardiac surgery: red cell distribution width to lymphocyte ratio

Seda Kurtbeyoğlu  1 , Aslı Demir  1 , Eda Balcı  1 , Hülya Yiğit Özay  1 , Bilal Katipoğlu  2 , Hayrettin Levent Mavioğlu  3
Affiliations

A new hematologic predictor of major adverse events after cardiac surgery: red cell distribution width to lymphocyte ratio

Seda Kurtbeyoğlu et al. Anesth Pain Med (Seoul). 2023 Jul.

Abstract

Background: The perioperative risk factors that cause severe morbidity and prolongation of postoperative hospital stay after cardiac surgery should be determined. Various scores have been used to predict morbidity and mortality. Preoperative blood counts are considered potential biomarkers of inflammation and oxidative stress. Inflammatory and immune imbalances may have a significant impact on postoperative adverse events. The present study aimed to investigate the association and potential predictive properties of red cell distribution width/ lymphocyte ratio (RLR) for major adverse events in adult patients who underwent coronary surgery with cardiopulmonary bypass.

Methods: After approval from the ethics committee, pre- and post-operative data of 700 patients were obtained from the electronic database of the hospital, intra- and post-operative anesthesia, and intensive care unit follow-up charts. We performed a stepwise multiple logistic regression analysis to investigate the association of RLR with major adverse events in adult patients who underwent coronary surgery with cardiopulmonary bypass.

Results: Among 700 patients, 47 (6.7%) had major adverse events after surgery. Multivariate logistic regression analysis showed that age (odds ratio [OR], 1.08; 95% confidence interval [CI], 1.03-1.12; P < 0.001), mean platelet volume (OR, 1.49; 95% CI, 1.07-2.06; P = 0.017), and RLR (OR, 1.21; 95% CI, 1.02-1.43; P = 0.026) were significantly associated with major adverse events.

Conclusions: RLR indicates the balance between inflammatory and immune responses. Therefore, it can be used to predict adverse events following coronary surgery.

Keywords: Blood cell count; Cardiac surgical procedures; Erythrocyte indices; Inflammatory and immune imbalances; Preoperative blood counts..

PubMed Disclaimer

Conflict of interest statement

CONFLICTS OF INTEREST

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1.
Fig. 1.
Diagonal segments are produced by ties. ROC: receiver operating characteristic, RLR: red cell distribution width to lymphocyte ratio, MPV: mean platelet volume.
See this image and copyright information in PMC

References

    1. Mazzeffi M, Zivot J, Buchman T, Halkos M. In-hospital mortality after cardiac surgery: patient characteristics, timing, and association with postoperative length of intensive care unit and hospital stay. Ann Thorac Surg. 2014;97:1220–5. - PubMed
    1. Bauer A, Korten I, Juchem G, Kiesewetter I, Kilger E, Heyn J. EuroScore and IL-6 predict the course in ICU after cardiac surgery. Eur J Med Res. 2021;26:29. - PMC - PubMed
    1. Urbanowicz T, Olasińska-Wiśniewska A, Michalak M, Rodzki M, Witkowska A, Straburzyńska-Migaj E, et al. The prognostic significance of neutrophil to lymphocyte ratio (NLR), monocyte to lymphocyte ratio (MLR) and platelet to lymphocyte ratio (PLR) on long-term survival in off-pump coronary artery bypass grafting (OPCAB) procedures. Biology (Basel) 2021;11:34. - PMC - PubMed
    1. Aydınlı B, Demir A, Güçlü ÇY, Bölükbaşı D, Ünal EU, Koçulu R, et al. Hematological predictors and clinical outcomes in cardiac surgery. J Anesth. 2016;30:770–8. - PubMed
    1. Haran C, Gimpel D, Clark H, McCormack DJ. Preoperative neutrophil and lymphocyte ratio as a predictor of mortality and morbidity after cardiac surgery. Heart Lung Circ. 2021;30:414–8. - PubMed

LinkOut - more resources