10.6084/M9.FIGSHARE.14883130.V1
Yang Li
Yang
Li
Zhouping Zou
Zhouping
Zou
Yunlu Zhang
Yunlu
Zhang
Bowen Zhu
Bowen
Zhu
Yichun Ning
Yichun
Ning
Bo Shen
Bo
Shen
Chunsheng Wang
Chunsheng
Wang
Zhe Luo
Zhe
Luo
Jiarui Xu
Jiarui
Xu
Xiaoqiang Ding
Xiaoqiang
Ding
Dynamics in perioperative neutrophil-to-lymphocyte*platelet ratio as a predictor of early acute kidney injury following cardiovascular surgery
<p>In this study, we applied a composite index of neutrophil-lymphocyte * platelet ratio (NLPR), and explore the significance of the dynamics of perioperative NLPR in predicting cardiac surgery-associated acute kidney injury (CSA-AKI).</p> <p>During July 1<sup>st</sup> and December 31<sup>th</sup> 2019, participants were prospectively derived from the ‘Zhongshan Cardiovascular Surgery Cohort’. NLPR was determined using neutrophil counts, lymphocyte and platelet count at the two-time points. Dose-response relationship analyses were applied to delineate the non-linear odds ratio (OR) of CSA-AKI in different NLPR levels. Then NLPRs were integrated into the generalized estimating equation (GEE) to predict the risk of AKI.</p> <p>Of 2449 patients receiving cardiovascular surgery, 838 (34.2%) cases developed CSA-AKI with stage 1 (<i>n</i> = 658, 26.9%), stage 2–3 (<i>n</i> = 180, 7.3%). Compared with non-AKI patients, both preoperative and postoperative NLPR were higher in AKI patients (1.1[0.8, 1.8] vs. 0.9[0.7,1.4], <i>p</i> < 0.001; 12.4[7.5, 20.0] vs. 10.1[6.4,16.7], <i>p</i> < 0.001). Such an effect was a ‘J’-shaped relationship: CSA-AKI’s risk was relatively flat until 1.0 of preoperative NLPR and increased rapidly afterward, with an odds ratio of 1.13 (1.06–1.19) per 1 unit. Similarly, patients whose postoperative NLPR value >11.0 were more likely to develop AKI with an OR of 1.02. Integrating the dynamic NLPRs into the GEE model, we found that the AUC was 0.806(95% CI 0.793–0.819), which was significantly higher than the AUC without NLPR (0.799, <i>p</i> < 0.001).</p> <p>Dynamics of perioperative NPLR is a promising marker for predicting acute kidney injury. It will facilitate AKI risk management and allow clinicians to intervene early so as to reverse renal damage.</p>
Space Science
Medicine
Cell Biology
Physiology
Immunology
Mathematical Sciences not elsewhere classified
Developmental Biology
Marine Biology
Taylor & Francis
2021
2021-06-30
2024-02-13
Journal contribution
389249 Bytes
10.6084/m9.figshare.14883130
10.1080/0886022X.2021.1937220
CC BY 4.0