title: Preoperative total lymphocyte count in peripheral blood as a predictor of poor outcome in adult cardiac surgery.
abstract: OBJECTIVE
  The aim of this study was to investigate the prognostic value of the preoperative total lymphocyte count in peripheral blood as a predictor of postoperative complications and mortality in cardiac surgery.
  
  
  METHODS
  A retrospective, observational study.
  
  
  METHODS
  The Novosibirsk State Research Institute of Circulation Pathology (single institution).
  
  
  METHODS
  All adults undergoing primary cardiopulmonary bypass in 2009.
  
  
  METHODS
  None.
  
  
  RESULTS
  The cohort size was 1,368 patients operated upon with cardiopulmonary bypass. Patient characteristics, hospital mortality, postoperative complications, ventilation time, intensive care unit, and hospital stay were analyzed. A preoperative total lymphocyte count <1,500 cells/μL was associated with significantly higher mortality by univariate (p < 0.0001) and multivariate (p < 0.044) analyses. A low preoperative total lymphocyte count was associated with more frequent inotropic support (p < 0.001); postoperative heart arrhythmia (p < 0.001); dialysis-dependent acute renal failure (p < 0.001); and a prolonged ventilation time (p = 0.001), intensive care unit stay (p < 0.001), and hospital stay (p = 0.007).
  
  
  CONCLUSIONS
  A low preoperative total lymphocyte count in peripheral blood is a useful prognostic criterion for the evaluation of a complicated postoperative period in cardiac patients operated under cardiopulmonary bypass.
authors.affiliation: Department of Anaestesiology and Intensive Care, Federal State Institution Academician EN Meshalkin Novosibirsk State Research Institute of Circulation Pathology Rusmedtechnology, Novosibirsk, Russia.
authors.forename: Vladimir V
authors.initials: VV
authors.lastname: Lomivorotov
authors.forename: Sergey M
authors.initials: SM
authors.lastname: Efremov
authors.forename: Vladimir A
authors.initials: VA
authors.lastname: Boboshko
authors.forename: Ilya N
authors.initials: IN
authors.lastname: Leyderman
authors.forename: Vladimir N
authors.initials: VN
authors.lastname: Lomivorotov
authors.forename: Albert T
authors.initials: AT
authors.lastname: Cheung
authors.forename: Alexander M
authors.initials: AM
authors.lastname: Karaskov
mesh_terms: D000368:Aged; D019540:Area Under Curve; D001145:Arrhythmias, Cardiac / Q000453:epidemiology / Q000209:etiology; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000401:mortality; D002315:Cardiopulmonary Bypass; D002316:Cardiotonic Agents / Q000627:therapeutic use; D015331:Cohort Studies; D016001:Confidence Intervals; D003422:Critical Care / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007239:Infections / Q000453:epidemiology; D017114:Liver Failure, Acute / Q000453:epidemiology / Q000209:etiology; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D019106:Postoperative Hemorrhage / Q000453:epidemiology; D011237:Predictive Value of Tests; D057234:Preoperative Period; D011379:Prognosis; D012372:ROC Curve; D006435:Renal Dialysis; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D002316:Cardiotonic Agents