Can Peroperative Neutrophil To Lymphocyte Ratio Change (Deltanlr) Be Used as a Parameter in Predicting Acute Renal Failure Following Coronary Bypass Operations With Cardiopulmonary Bypass?

Background

Inflammation plays a significant role in the pathogenesis of many diseases as well as postoperative acute renal failure (ARF). Preoperative neutrophil to lymphocyte ratio (NLR) values have a prognostic value for postoperative ARF after cardiovascular surgeries.

Methods

Patients who underwent elective coronary artery bypass graft (CABG) with cardiopulmonary bypass in our clinic between December 15, 2015 and December 15, 2019, retrospectively were included in this study. Patients who did not develop ARF after the operation were categorized as Group 1, and patients who did were included in Group 2. NLR was calculated from the hemograms during three periods (Preoperative (Pre), Postcardiotomy (Pc),
Postoperative Day 1 (Po1). DeltaNLR1 (PcNLR- PreNLR) and DeltaNLR2 (Po1NLR-PreNLR) values were obtained from these calculated values.

Results

The mean ages of patients in Group 1 (N = 274) and Group 2 (N = 61) were 60 ± 9.1 years and 67.7 ± 9.8 years, respectively (P < .001). In the multivariate analysis, being over 65 years of age (Odds ratio [OR]: 1.074, 95% confidence interval [CI]: 1.012-1.194, P = .030), postoperative inotropic need (OR: 0.678, CI 95%: 0.395-0.819, P = .021), increased blood product use (OR: 0.916, CI 95%: 0.779-0.986,
P = .034), preoperative creatinine increase (OR: 1.974, CI 95%: 1.389-4.224, P = .007), PcNLR (OR : 1.988, CI 95%: 1.765-3.774, P <.001), Po1NLR (OR: 1.090, CI 95%: 1.007-2.116, P = .028), DeltaNLR1 (OR: 3.090, CI 95%: 1.698-6.430, P < .001) and DeltaNLR2 (OR: 1.676, CI 95%: 1.322-2.764, P = .003) were identified as independent predictors for predicting postoperative ARF.

Conclusion

In this study, we have shown that peroperative NLR changes can be used as an effective parameter to predict ARF developing following CABG operations.