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White blood cell count and new-onset atrial fibrillation after cardiac surgery.
- Source :
-
International journal of cardiology [Int J Cardiol] 2017 Feb 01; Vol. 228, pp. 971-976. Date of Electronic Publication: 2016 Nov 17. - Publication Year :
- 2017
-
Abstract
- 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.<br />Methods: Patients ≥18years, 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 (ΔWBC and ΔN/L ratio respectively). Development of PNAF was evaluated in all patients with continuous 12-lead ECG monitoring.<br />Results: 657 patients were included and 277 (42%) developed PNAF. Univariable analyses showed a statistically significant relationship between ΔWBC (P=0.030) and ΔN/L ratio (P=0.002), and PNAF. In multivariable analysis no significant relationship was found between ΔWBC (OR: 1.14 per 1×10 <superscript>9</superscript> /L increase; 95% CI: 0.65-2.03; P=0.645), ΔN/L ratio (OR: 1.65 per 1×10 <superscript>9</superscript> /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.<br />Conclusions: The perioperative WBC response and its components were not associated with the development of PNAF.<br /> (Copyright © 2016 Swiss Tropical and Public Health Institute. Published by Elsevier Ireland Ltd.. All rights reserved.)
- Subjects :
- Adult
Aged
Analysis of Variance
Atrial Fibrillation blood
Atrial Fibrillation mortality
Biomarkers blood
Cardiac Surgical Procedures methods
Cohort Studies
Databases, Factual
Elective Surgical Procedures methods
Female
Follow-Up Studies
Hospital Mortality
Humans
Male
Middle Aged
Multivariate Analysis
Netherlands
Perioperative Care methods
Postoperative Complications blood
Postoperative Complications mortality
Postoperative Complications physiopathology
Prospective Studies
Risk Assessment
Survival Analysis
Atrial Fibrillation etiology
Cardiac Surgical Procedures adverse effects
Elective Surgical Procedures adverse effects
Leukocyte Count methods
Subjects
Details
- Language :
- English
- ISSN :
- 1874-1754
- Volume :
- 228
- Database :
- MEDLINE
- Journal :
- International journal of cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 27914360
- Full Text :
- https://doi.org/10.1016/j.ijcard.2016.11.038