title: Value of the neutrophil-to-lymphocyte ratio in predicting post-pericardiotomy syndrome after cardiac surgery.
abstract: OBJECTIVE
  Post-pericardiotomy syndrome (PPS) occurs in 10-40% of patients after cardiac surgery. PPS is considered an autoimmune phenomenon. The neutrophil-to-lymphocyte ratio (NLR) is a novel inflammatory marker that is associated with various cardiovascular diseases. Studies have reported that the NLR increases in certain autoimmune diseases. This study examined whether the NLR is helpful to predict the occurrence of PPS after elective on-pump coronary artery bypass graft (CABG) surgery.
  
  
  METHODS
  The records of patients who underwent elective first-time on-pump CABG were reviewed retrospectively. In total, 72 patients with PPS were included in the study, and 100 patients who did not develop PPS were included as the control group. Peripheral blood samples collected preoperatively and on postoperative day 1 were used to calculate the NLR.
  
  
  RESULTS
  No differences in preoperative white blood cell (WBC) count, neutrophil count, lymphocyte count, or NLR were observed between the patients with PPS and the control group. The WBC (p < 0.001) and neutrophil counts (p < 0.001) and NLR (p = 0.01) were significantly higher during the postoperative period in patients with PPS than in the control group. A receiver operating characteristic curve analysis showed that the postoperative NLR predicted PPS with 60% sensitivity and 59% specificity (area under the curve, 0.61; 95% confidence interval [CI], 0.51-0.70; p = 0.017), using a cut-off of 8.34. The postoperative WBC count (odds ratio [OR], 1.6; 95% CI, 1.36-2.03; p < 0.001) and NLR (OR, 3.3; 95% CI, 1.56-7.01; p = 0.002) were independently associated with PPS.
  
  
  CONCLUSIONS
  The postoperative NLR may be useful to predict the development of PPS in patients undergoing on-pump CABG.
authors.affiliation: Department of Cardiovascular Surgery, Diyarbakir Gazi Yasargil Education and Research Hospital, Diyarbakir, Turkey. utkansevuk@gmail.com.
authors.forename: U
authors.initials: U
authors.lastname: Sevuk
authors.forename: A
authors.initials: A
authors.lastname: Bilgic
authors.forename: R
authors.initials: R
authors.lastname: Altindag
authors.forename: E
authors.initials: E
authors.lastname: Baysal
authors.forename: B
authors.initials: B
authors.lastname: Yaylak
authors.forename: M S
authors.initials: MS
authors.lastname: Adiyaman
authors.forename: S
authors.initials: S
authors.lastname: Akkaya
authors.forename: N
authors.initials: N
authors.lastname: Ay
authors.forename: V
authors.initials: V
authors.lastname: Alp
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D001026:Coronary Artery Bypass / Q000009:adverse effects; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008214:Lymphocytes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000473:pathology*; D010492:Pericardiectomy / Q000009:adverse effects*; D011185:Postpericardiotomy Syndrome / Q000097:blood / Q000175:diagnosis*; D011379:Prognosis; D012189:Retrospective Studies
chemical_list: D015415:Biomarkers