PDF(Pubmed)
Abstract：
BACKGROUND: Neutrophil-lymphocyte ratio (NLR) is a valuable indicator for evaluating inflammatory response and red blood cell distribution width (RBDW), a routinely available biomarker of likely erythropoietic dysfunction, which may be associated with adverse outcomes after cardiac surgery. This study aimed to investigate the association between these two readily available haematological parameters, with the poor outcomes in paediatric patients undergoing cardiac surgery.
METHODS: A comprehensive review of medical records for paediatric patients who underwent cardiac surgery at our tertiary care centre between April 2022 and June 2023 was carried out. RBDW and NLR values were collected from complete blood count reports obtained on admission to the ICU. Demographic data, surgical details, and postoperative complications were also recorded. A receiver operating characteristic (ROC) curve and multivariable logistic regression were applied to identify the prognosis performance of preoperative NLR and RBDW for poor outcomes.
RESULTS: The study included 219 patients meeting the inclusion criteria of which a total of 90 (41%) children experienced at least one of the poor outcomes. Preoperative NLR (AUC=0.88, 95%CI 0.36-0.70, cut off- 4.2) and RBDW (AUC=0.88, 95%CI 0.39-0.73, cut off- 18.5%) showed prognostic significance in the perioperative period.
CONCLUSIONS: This retrospective observational study highlights a significant association between elevated Red Blood Cell Distribution Width (RBDW) and Neutrophil Lymphocyte Ratio (NLR) values and poor outcomes in paediatric patients undergoing cardiac surgery. These readily available haematological parameters could serve as potential prognostic indicators for identifying patients at risk of poor outcomes.
METHODS: A comprehensive review of medical records for paediatric patients who underwent cardiac surgery at our tertiary care centre between April 2022 and June 2023 was carried out. RBDW and NLR values were collected from complete blood count reports obtained on admission to the ICU. Demographic data, surgical details, and postoperative complications were also recorded. A receiver operating characteristic (ROC) curve and multivariable logistic regression were applied to identify the prognosis performance of preoperative NLR and RBDW for poor outcomes.
RESULTS: The study included 219 patients meeting the inclusion criteria of which a total of 90 (41%) children experienced at least one of the poor outcomes. Preoperative NLR (AUC=0.88, 95%CI 0.36-0.70, cut off- 4.2) and RBDW (AUC=0.88, 95%CI 0.39-0.73, cut off- 18.5%) showed prognostic significance in the perioperative period.
CONCLUSIONS: This retrospective observational study highlights a significant association between elevated Red Blood Cell Distribution Width (RBDW) and Neutrophil Lymphocyte Ratio (NLR) values and poor outcomes in paediatric patients undergoing cardiac surgery. These readily available haematological parameters could serve as potential prognostic indicators for identifying patients at risk of poor outcomes.
摘要：
背景：中性粒细胞-淋巴细胞比率（NLR）是评估炎症反应和红细胞分布宽度（RBDW）的有价值的指标，一种可能的红细胞生成功能障碍的常规生物标志物，这可能与心脏手术后的不良后果有关。这项研究旨在调查这两个容易获得的血液学参数之间的关联，在接受心脏手术的儿科患者中效果不佳。
方法：对2022年4月至2023年6月在我们的三级护理中心接受心脏手术的儿科患者的病历进行了全面审查。从入住ICU时获得的全血细胞计数报告中收集RBDW和NLR值。人口统计数据,手术细节,记录术后并发症。应用受试者工作特征（ROC）曲线和多变量逻辑回归来确定不良结局的术前NLR和RBDW的预后表现。
结果：该研究包括219名符合纳入标准的患者，其中90名（41%）儿童经历了至少一种不良结局。术前NLR(AUC=0.88,95CI0.36-0.70,cutoff-4.2)和RBDW(AUC=0.88,95CI0.39-0.73,cutoff-18.5%)在围手术期显示预后意义。
结论：这项回顾性观察研究强调了红细胞分布宽度(RBDW)和中性粒细胞淋巴细胞比率(NLR)值升高与接受心脏手术的儿科患者预后不良之间的显著关联。这些容易获得的血液学参数可以作为潜在的预后指标，用于识别有不良预后风险的患者。
方法：对2022年4月至2023年6月在我们的三级护理中心接受心脏手术的儿科患者的病历进行了全面审查。从入住ICU时获得的全血细胞计数报告中收集RBDW和NLR值。人口统计数据,手术细节,记录术后并发症。应用受试者工作特征（ROC）曲线和多变量逻辑回归来确定不良结局的术前NLR和RBDW的预后表现。
结果：该研究包括219名符合纳入标准的患者，其中90名（41%）儿童经历了至少一种不良结局。术前NLR(AUC=0.88,95CI0.36-0.70,cutoff-4.2)和RBDW(AUC=0.88,95CI0.39-0.73,cutoff-18.5%)在围手术期显示预后意义。
结论：这项回顾性观察研究强调了红细胞分布宽度(RBDW)和中性粒细胞淋巴细胞比率(NLR)值升高与接受心脏手术的儿科患者预后不良之间的显著关联。这些容易获得的血液学参数可以作为潜在的预后指标，用于识别有不良预后风险的患者。
