Predicting postoperative ischemic stroke problems in patients following coronary bypass surgery using neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, and red blood cell distribution width values

Derya Tatlisuluoglu; Büşra Tezcan; İbrahim Mungan; Yaşar Alp Çakirli; Naim Boran Tümer; İrfan Taşoğlu

doi:10.5114/kitp.2022.117499

Predicting postoperative ischemic stroke problems in patients following coronary bypass surgery using neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, and red blood cell distribution width values

Kardiochir Torakochirurgia Pol. 2022 Jun;19(2):90-95. doi: 10.5114/kitp.2022.117499. Epub 2022 Jun 29.

Authors

Derya Tatlisuluoglu¹, Büşra Tezcan², İbrahim Mungan³, Yaşar Alp Çakirli¹, Naim Boran Tümer⁴, İrfan Taşoğlu⁴

Affiliations

¹ Department of Intensive Care Unit, Istanbul Cam and Sakura Education and Research City Hospital, Istanbul, Turkey.
² Department of Intensive Care Unit, Ankara Education and Research City Hospital, Ankara, Turkey.
³ Department of Intensive Care Unit, Kahramanmaraş Necip Fazıl Education and Research City Hospital, Kahramanmaraş, Turkey.
⁴ Department of Cardiovascular Surgery, Ankara Education and Research City Hospital, Ankara, Turkey.

Abstract

Introduction: Coronary artery bypass grafting (CABG) plays an important role in the revascularization of ischemic heart disease. However, stroke is a rare but extremely serious complication after CABG.

Aim: We investigated the relationship between platelet-lymphocyte ratio (PLR), neutrophil-lymphocyte ratio, red blood cell distribution width (RDW) values, and postoperative ischemic stroke by examining the preoperative complete blood count (CBC) parameters in patients who underwent CABG.

Material and methods: A total of 1240 patients who underwent CABG between September 2016 and June 2019 were included in this retrospective observational study. The diagnosis of ischemic stroke was made in the postoperative period by neurology consultation and radiological imaging. The CBC data used as preoperative values for each case were obtained the day before surgery.

Results: Ischemic stroke was observed in 40 patients. In patients with stroke, the mean age was higher, the hemoglobin (HB) value and lymphocyte count were lower (p < 0.001), and there were also higher neutrophil to lymphocyte ratio (NLR), PLR, and RDW values (p < 0.001), number of mechanical ventilator days, length of stay in the hospital, and length of stay in the ICU (p < 0.001). Statin and acetylsalicylic acid use were statistically significantly higher in patients without ischemic stroke after CABG (p < 0.001); the use of other antiaggregants was found to be higher in stroke patients (p < 0.05). However, age, operation time, PLR, NLR, and RDW values were determined as independent risk factors for ischemic stroke.

Conclusions: In patients undergoing CABG, high preoperative PLR, NLR, and RDW values can be used as useful and independent risk factors for the prediction of postoperative ischemic stroke.

Keywords: coronary artery bypass grafting; ischemic stroke; neutrophil-lymphocyte ratio; platelet-lymphocyte ratio; red blood cell distribution width.

Copyright: © 2022 Polish Society of Cardiothoracic Surgeons (Polskie Towarzystwo KardioTorakochirurgów) and the editors of the Polish Journal of Cardio-Thoracic Surgery (Kardiochirurgia i Torakochirurgia Polska).