The relationship of lactic acid, neutrophil lymphocyte ratio and monocyte lymphocyte ratio with the outcomes of coronary arterial disease patients following coronary artery bypass surgery

Background: Coronary artery bypass surgery (CABG) is a surgical procedure for coronary arterial disease (CAD). It has a risk of postoperative complication, extending from a long length of stay in the intensive care unit (ICU) to death. CABG needs a long duration of perioperative time, which decreases tissue oxygenation. It causes increased lactic acid production and initiates the secretion of inflammatory factors. Neutrophil/lymphocyte ratio (NLR) and monocyte/lymphocyte ratio (MLR) become inflammatory signs that are caused by the failure of heart microcirculation during the operative procedure. This study aimed to determine the relationship of lactic acid, NLR and MLR with the outcomes of CAD patients following CABG surgery. Methods: This was a prospective study including 42 CAD patients who had undergone CABG procedure at Dr. Kariadi Hospital Semarang between December 2017 and July 2018. Lactic acid data were taken using the spectrophotometer method. NLR and MLR were taken by the calculation index. The outcomes data were ICU length of stay (LoS), complications, and death, which were obtained from the medical record. The data were analyzed using bivariate analysis. Results: There was a significant correlation between lactic acid with ICU LoS (p = 0.001), complication (p = 0.01), and mortality (p = 0.044). There was a significant correlation between NLR with ICU LoS (p = 0.003), complication (p = 0.009), and mortality (p = 0.014). There was a significant correlation between MLR with ICU LoS (p = 0.02), complication (p = 0.027), and mortality (p = 0.017). Conclusion: There was a significant correlation between lactic acid, NLR dan MLR with the outcomes of CAD patients (ICU LoS, complication and mortality) that have undergone CABG procedure.