Predictive significance of hematological indices in aortic reconstructive surgery: a prospective observational study

Abstract

INTRODUCTION: Hematological indices are available, universal predictors and markers of infectious and non-infectious pathological conditions. OBJECTIVE: To determine the predictive ability of hematological indices in relation to the development of postoperative complications in patients undergoing reconstructive interventions on the aorta. MATERIALS AND METHODS: A prospective, observational, single-center study included 79 patients who underwent elective aortic surgery under cardiopulmonary bypass. Age of participants 57 (46.5; 64) years, Charlson comorbidity index 4 (2; 5), cardiopulmonary bypass duration 123 (101; 160) minutes, myocardial ischemia 91 (66; 115) minutes. The patients were divided into two groups: I — without complications, II — with complications. RESULTS: Neutrophil to lymphocyte ratio (NLR) on day 3 in group I was 6.17 (4.1; 8.7), in group II — 9.56 (6.68; 12.46), p = 0.002. NLR on day 6 in group I was 3.79 (2.77; 5.1), in group II — 6.0 (4.3; 9.1), p = 0.001. NLR > 7.5 on day 3 was a predictor of complications in the postoperative period, OR = 4.6 (95 % CI 1.8–11.9, p = 0.002). NLR on day 6 > 5.0 also showed a predictive ability: OR = 4.9 (95 % CI 1.9–12.7, p = 0.001). Platelet to lymphocyte ratio (PLR) on day 3 in group I was 103.88 (78.87; 133.57), by day 6 it increased to 117.5 (104.63; 160.78); in group II, there was practically no increase in PLR: from 122 (88.46; 160.25) to 127.06 (108.40; 154.14). Differences between the indicators in groups were not statistically significant. CONCLUSIONS: Hematological indices can be used as predictors of complications in patients after surgery on the aorta and its branches. Patients with NLR > 7.5 on day 3 and > 5.0 on day 6, regardless of comorbidities and age, may represent a previously unrecognized subgroup of patients with an increased risk of postoperative complications.