White blood cell count and new-onset atrial fibrillation after cardiac surgery

被引:17
作者
Jacob, Kirolos A. [1 ,2 ]
Buijsrogge, Marc P. [1 ]
Frencken, Jos F. [2 ]
ten Berg, Maarten J. [3 ]
Suyker, Willem J. L. [1 ]
van Dijk, Diederik [1 ]
Dieleman, Jan M. [1 ]
机构
[1] Univ Med Ctr, Dept Cardiothorac Surg, Mail Stop E03-511-POB 85500,Heidelberglaan 100, NL-3508 GA Utrecht, Netherlands
[2] Univ Med Ctr, Dept Anesthesiol & Intens Care Med, Utrecht, Netherlands
[3] Univ Med Ctr, Dept Clin Chem & Hematol, Utrecht, Netherlands
关键词
Atrial fibrillation; Inflammatory response; Inflammatory cells; Perioperative care; Cardiac surgery; ARTERY-BYPASS SURGERY; C-REACTIVE PROTEIN; CONTROLLED-TRIAL; CORONARY-BYPASS; DEXAMETHASONE; INFLAMMATION; PREVENTION; MORTALITY; SYSTEM;
D O I
10.1016/j.ijcard.2016.11.038
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Postoperative new-onset atrial fibrillation (PNAF) is the most common complication following cardiac surgery. The inflammatory response, as a potential underlying mechanism, has been extensively studied. In small studies, the white blood cell count (WBC) has been shown to be the only consistent inflammatory marker associated with PNAF. This study aimed to determine the association between perioperative WBC response and PNAF in a larger study cohort. Methods: Patients >= 18 years, undergoing elective cardiac surgery with a preoperative sinus rhythm were included. WBC was routinely measured preoperatively, and daily during the first four postoperative days. Main outcomes were the difference between peak postoperative WBC and neutrophil/lymphocyte ratio (N/L ratio) and preoperative WBC and N/L ratio (Delta WBC and Delta N/L ratio respectively). Development of PNAF was evaluated in all patients with continuous 12-lead ECG monitoring. Results: 657 patients were included and 277 (42%) developed PNAF. Univariable analyses showed a statistically significant relationship between Delta WBC (P= 0.030) and Delta N/L ratio (P= 0.002), and PNAF. Inmultivariable analysis no significant relationship was found between Delta WBC (OR: 1.14 per 1 x 10(9)/L increase; 95% CI: 0.65-2.03; P = 0.645),Delta N/L ratio (OR: 1.65 per 1 x 10(9)/L increase; 95% CI: 0.94-2.90; P = 0.089), and PNAF. Increasing age (OR: 1.08 per year; 95% CI: 1.01-1.16; P = 0.022) and (additional) valve surgery (versus CABG) (OR: 4.96; 95% CI: 2.07-6.91; P = 0.001) were associated with PNAF. Conclusions: The perioperative WBC response and its components were not associated with the development of PNAF. (C) 2016 The Authors. Published by Elsevier Ireland Ltd.
引用
收藏
页码:971 / 976
页数:6
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