Association of preoperative and postoperative systemic inflammatory markers with early mortality and morbidity after CABG surgery.

OBJECTIVE

This study aimed to investigate the relationship between preoperative and postoperative inflammatory parameters—including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII)—and early clinical outcomes in patients undergoing isolated coronary artery bypass graft (CABG) surgery.

METHODS

In this single-center, retrospective clinical study, data from 500 adult patients who underwent elective, isolated on-pump CABG surgery between 2018 and 2023 were analyzed. Preoperative and postoperative (day 1 and day 7) complete blood count parameters, as well as early postoperative clinical outcomes (including mortality, atrial fibrillation, length of ICU and hospital stay, and other complications), were systematically evaluated. Multivariate logistic regression was used to identify independent predictors of early mortality.

RESULTS

Patients who experienced early mortality had significantly higher preoperative NLR, PLR, SII, blood urea nitrogen, creatinine, and older age, as well as longer cardiopulmonary bypass and cross-clamp times. Postoperative day 7 values for NLR, PLR, SII, and neutrophil count were also significantly elevated in the mortality group, while lymphocyte and platelet counts were lower. Both preoperative and postoperative inflammatory markers were positively correlated with prolonged extubation time, length of ICU and hospital stay, and the occurrence of atrial fibrillation. In multivariate analysis, preoperative NLR, PLR, SII, and postoperative day 7 NLR and SII emerged as independent predictors of early mortality.

CONCLUSION

Elevated preoperative and postoperative inflammatory markers (NLR, PLR, and SII) are significantly associated with adverse early clinical outcomes after CABG surgery. Monitoring these parameters may facilitate early risk stratification and improve postoperative patient management.