Open AccessPrognostic Value of the Leuko-Glycaemic Index in the Postoperative Period of Coronary Artery Bypass Grafting
Author(s) -
Leonardo Seoane,
Lucrecia María Burgos,
Juan Espinoza,
Juan Furmento,
Mariano Benzadón,
Mariano Vrancic,
Fernando Piccinini,
Daniel Navia
Publication year - 2021
Publication title -
brazilian journal of cardiovascular surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.324
H-Index - 26
eISSN - 1678-9741
pISSN - 0102-7638
DOI - 10.21470/1678-9741-2020-0349
Subject(s) - medicine , quartile , clinical endpoint , cardiology , receiver operating characteristic , atrial fibrillation , bypass grafting , logistic regression , acute kidney injury , artery , surgery , confidence interval , randomized controlled trial
High leuko-glycaemic index (LGI) (> 2000) has been associated with poor prognosis in many critical care settings. However, there is no evidence of LGI’s prognostic value in the postoperative period of coronary artery bypass grafting (CABG). This study aims to analyze the prognostic value of LGI in the postoperative period of CABG. Methods Single-center retrospective analysis of prospectively collected data was performed. Consecutive adult patients undergoing CABG between 2007 and 2019 were included. Blood glucose levels and white blood cells count were evaluated in the immediate postoperative period. LGI was calculated by multiplying both values and dividing them by 1,000 and analyzed in quartiles. Receiver operating characteristic curve was used to determine the best cutoff value. The primary combined endpoint was in-hospital mortality, low cardiac output (LCO), or acute kidney injury (AKI). Secondary endpoints included in-hospital death, AKI, atrial fibrillation, and LCO. Results The study evaluated 3,813 patients undergoing CABG (88.5% male, 89.8% off-pump surgery, aged 64.6 years [standard deviation 9.6]). The median of LGI was 2,035. Presence of primary endpoint significantly increased per LGI quartile (9.2%, 9.7%, 11.8%, and 15%; P <0.001). High LGI was associated with increased occurrence of in-hospital mortality, LCO, AKI, and atrial fibrillation. The best prognostic cutoff value for primary endpoint was 2,000. In a multivariate logistic regression model, high LGI was independently associated with in-hospital death, LCO, or AKI. Conclusion High LGI was an independent predictor of in-hospital mortality, LCO, or AKI in postoperative period of CABG. It was also associated with higher in-hospital death.