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Journal of Anesthesia
Published in: Journal of Anesthesia 5/2016

01-10-2016 | Original Article

Hematological predictors and clinical outcomes in cardiac surgery

Authors: Bahar Aydınlı, Aslı Demir, Çiğdem Yıldırım Güçlü, Demet Bölükbaşı, E. Utku Ünal, Rabia Koçulu, Gökçe Selçuk

Published in: Journal of Anesthesia | Issue 5/2016

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Abstract

Purpose

The present study was to investigate if five values that are part of the hemogram analysis routinely checked before heart surgeries can be used as a high-quality, quick, low-cost, and easy-to-use outcome predictor.

Methods

This investigation was a retrospective, observational, cross-sectional study. Univariate and multivariate logistic regression was used to identify independent predictors for combined adverse events. We enrolled 1500 consecutive patients who underwent elective, on-pump, open-heart surgery from 2011 to 2014. Preoperative hemogram evaluation, red cell distribution width (RDW), mean platelet volume (MPV), platelet-to-lymphocyte ratio (PLR), and neutrophil-to-lymphocyte ratio (NLR) were recorded. We classified combined adverse events (CAE) as (1) myocardial infarction, (2) cardiac reoperation, (3) prolonged mechanical ventilation, (4) prolonged hospital stay, (5) rehospitalization, or (6) mortality.

Results

It was found that several parameters obtained as part of the hemogram, namely RDW, MPV, PLR, and NLR, can predict, individually or in combinations, the outcomes in open-heart surgery patients. It was found that the prediction success of NLR (4.8 fold) was higher compared to RDW (1.8 fold) and MPV (1.5 fold). When the prediction success of the combined parameters was investigated, the NLR–RDW (4.7 fold) pair was found higher in the prediction of CAE occurrence. The predictive success of the triple combination of NLR–MPV–RDW (5.5 fold) was higher than other combinations.

Conclusions

The triple combination of parameters obtained as part of the hemogram, NLR–RDW–MPV, indicated a much more predictive power than two parameters coupled. This combination of three parameters, NLR–RDW–MPV, is to be considered as a sensitive, high-quality, low-cost outcome prediction marker for cardiac surgery patients that is less time consuming and easy to use.
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Metadata
Title
Hematological predictors and clinical outcomes in cardiac surgery
Authors
Bahar Aydınlı
Aslı Demir
Çiğdem Yıldırım Güçlü
Demet Bölükbaşı
E. Utku Ünal
Rabia Koçulu
Gökçe Selçuk
Publication date
01-10-2016
Publisher
Springer Japan
Published in
Journal of Anesthesia / Issue 5/2016
Print ISSN: 0913-8668
Electronic ISSN: 1438-8359
DOI
https://doi.org/10.1007/s00540-016-2197-y

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