Neutrophil Counts, Neutrophil-to-Lymphocyte Ratio, and Systemic Inflammatory Response Index (SIRI) Predict Mortality after Off-Pump Coronary Artery Bypass Surgery

• Published in: Cells (Basel, Switzerland) Switzerland), 2022-03, Vol.11 (7), p.1124
• Main Authors: Urbanowicz, Tomasz, Michalak, Michał, Olasińska-Wiśniewska, Anna, Rodzki, Michał, Witkowska, Anna, Gąsecka, Aleksandra, Buczkowski, Piotr, Perek, Bartłomiej, Jemielity, Marek
• Format: Article
• Language: English
• Subjects: Aged; AISI; Blood platelets; Cardiovascular disease; Chronic obstructive pulmonary disease; Coronary artery; Coronary Artery Bypass, Off-Pump - adverse effects; Coronary vessels; Creatinine; Diabetes; Ejection fraction; Female; Heart surgery; Humans; Hypertension; Inflammation; Laboratories; Leukocytes (neutrophilic); Lymphocytes; Male; Medical prognosis; Middle Aged; Morbidity; Mortality; Neutrophils; NLR; OPCAB; Ostomy; Retrospective Studies; SII; SIRI; Stroke; Surgery; Systemic Inflammatory Response Syndrome; Vein & artery diseases
• ISSN: 2073-4409; 2073-4409
• DOI: 10.3390/cells11071124

Background: Several perioperative inflammatory markers are postulated to be significant factors for long-term survival after off-pump coronary artery bypass surgery (OPCAB). Hematological parameters, whether single or combined as indices, provide higher predictive values. Methods: The study group comprised 538 consecutive patients (125 (23%) females and 413 (77%) males) with a mean age of 65 ± 9 years, who underwent OPCAB with a mean follow-up time of 4.7 ± 1.7 years. This single-center retrospective analysis included perioperative inflammatory markers such as the neutrophil-to-lymphocyte ratio (NLR), systemic inflammatory response index (SIRI), aggregate index of systemic inflammation (AISI), and systemic inflammatory index (SII). Results: Multivariable analysis identified levels of neutrophils above 4.3 × 109/L (HR 13.44, 95% CI 1.05−3.68, p = 0.037), values of SIRI above 5.4 (HR 0.29, 95% CI 0.09−0.92, p = 0.036) and values of NLR above 3.5 (HR 2.21, 95% CI 1.48−3.32, p < 0.001) as being significant predictors of long-term mortality. The multifactorial models revealed the possibility of strong prediction by combining preoperative factors (COPD, stroke, PAD, and preoperative PLR) and postoperative neutrophil counts (p = 0.0136) or NLR (p = 0.0136) or SIRI (p = 0.0136). Conclusions: Among the postoperative inflammatory indices, the levels of neutrophils, NLR, and SIRI are the most prominent markers for long-term survival after off-pump coronary artery bypass surgery, when combined with preoperative characteristics.