Letter to Editor: Predictive value of neutrophil to lymphocyte ratio on acute kidney injury after on-pump coronary artery bypass: a retrospective, single-center study

• Published in: General thoracic and cardiovascular surgery Vol. 70; no. 9; pp. 832 - 833
• Main Authors: Das, Devishree, Magoon, Rohan
• Format: Journal Article
• Language: English
• Published: Singapore Springer Nature Singapore 01.09.2022; Springer Nature B.V
• Subjects: Cardiac Surgery; Cardiology; Conflicts of interest; Coronary vessels; Heart surgery; Kidneys; Letter to the Editor; Lymphocytes; Medicine; Medicine & Public Health; Neutrophils; Surgical Oncology; Thoracic Surgery; Veins & arteries; Confounding; Inflammatory prognostication; Low cardiac output syndrome; Cardiac surgery; Vasoactive-inotropic score; Acute kidney injury
• ISSN: 1863-6705; 1863-6713; 1863-6713
• DOI: 10.1007/s11748-022-01824-4

[...]Guangqing et al. study does not discuss the hemodynamic management protocol employed in their setting [1]. [...]the lack of account for low cardiac output syndrome (LCOS) incidence or intra-aortic balloon pump (IABP) use merits attention, particularly amidst Yi et al. delineating postoperative LCOS and intraoperative IABP use as important CSA-AKI predictors (OR; 95% CI; p value: 2.30; 1.05–5.04; 0.04 and 4.44; 2.37–8.30; < 0.00001, respectively) in a meta-analysis including 2157 cases and 49,777 controls [4]. [...]Guangqing et al. additionally overlook the contextual vasopressor-inotropic requirements. [...]the absence of blood-transfusion and glucose-homeostasis regimen in the Guangqing et al. study is also difficult to neglect when perioperative transfusions and glycemic fluctuations have been linked to an accentuated risk for CSA-AKI [1, 6, 7] While parsimonious inflammatory prognostication is indeed a welcome inclusion to the risk-stratification repertoire [8], a comprehensive approach is pivotal to a sound understanding of the research subject.