Correlation of neutrophil-to-lymphocyte ratio with prolonged ICU stayin infants undergoing cardiac surgery

Background The neutrophil-to-lymphocyte ratio(NLR)stands as a valuable marker for assessing inflammation and predicting adverse outcomes post-cardiac surgery.This study aimed to ascertain the prognostic relevance of preoperative NLR concerning prolonged ICU stay among infants undergoing congenital heart surgery employing cardiopulmonary bypass.Methods A retrospective review was conducted involving 187 consecutive infants(≤1 year)who underwent congenital heart disease surgery between January and April 2019,stratified into two groups based on NLR(NLR<0.484,NLR≥0.484).The primary outcome was prolonged intensive care unit(ICU)length of stay,defined patients with ICU stays duration higher than the third quartile.Correlations between preoperative NLR and clinical outcomes were assessed.Receiver operating characteristic curve analysis,multivariable Logistic regression,and restricted cube plots were utilized to gauge the association of preoperative NLR with prolonged ICU stay.Results The area under the receiver operating characteristic curve of NLRpredictive capability for prolonged ICU length of staywas 0.691.Subgroup analyses revealed poorer prognoses among patients with high NLR(≥0.484).Multivariable Logistic regression analysis indicated that heightened preoperative NLR(OR:2.63,95%CI:1.18-5.83,P=0.018)independently was correlated with prolonged ICU length of stay in infants'post-cardiac surgery.Conclusions In summary,the NLR emerges as a significant predictive factor for prolonged ICU stay in infants undergoing cardiac surgery.Nevertheless,further research is warranted to comprehensively grasp the relationship between the NLR and prolonged ICU stay.

C-reactive protein as a non-linear predictor of prolonged length of intensive care unit stay after gastrointestinal cancer surgery

BACKGROUND The relationship between C-reactive protein(CRP)levels and prolonged intensive care unit(ICU)length of stay(LoS)has not been well defined.AIM To explore the association between CRP levels at ICU admission and prolonged ICU LoS in gastrointestinal cancer(GC)patients after major surgery.METHODS A retrospective study was performed to quantify serum CRP levels and to establish their association with prolonged ICU LoS(≥72 h)in GC patients admitted to the ICU.Univariate and multivariate regression analyses were conducted,and restricted cubic spline curves with four knots(5%,35%,65%,95%)were used to explore non-linearity assumptions.RESULTS A total of 408 patients were enrolled.Among them,83(20.3%)patients had an ICU LoS longer than 72 h.CRP levels were independently associated with the risk of prolonged ICU LoS[odds ratio(OR)1.47,95%confidence interval(CI)1.00–2.17].Restricted cubic spline analysis revealed a non-linear relationship between CRP levels and OR for the prolonged ICU LoS(P=0.035 for nonlinearity).After the cut-off of 2.6(log transformed mg/L),the OR for prolonged ICU LoS significantly increased with CRP levels.The adjusted regression coefficient was 0.70(95%CI 0.31–1.57,P=0.384)for CRP levels less than 2.6,whereas it was 2.43(95%CI 1.39–4.24,P=0.002)for CRP levels higher than 2.6.CONCLUSION Among the GC patients,CRP levels at ICU admission were non-linearly associated with prolonged ICU LoS in survivors.An admission CRP level>2.6(log transformed mg/L)was associated with increased risk of prolonged ICU LoS.