Key result
Higher postoperative neutrophil-to-lymphocyte ratio predicts pulmonary complications after pediatric open-heart surgery.
Why the study?
The study aimed to investigate the incidence and predisposing factors of pulmonary complications in pediatric patients undergoing cardiac surgery and its relationship with the neutrophil-to-lymphocyte ratio.
Does the neutrophil-to-lymphocyte ratio predict pulmonary complications in pediatric patients undergoing cardiac surgery?
Cohort (n=457)
No
Does the neutrophil-to-lymphocyte ratio predict pulmonary complications in pediatric patients undergoing cardiac surgery?
In pediatric patients undergoing cardiac surgery, pulmonary complications occurred in 15.8% of cases, and the neutrophil-to-lymphocyte ratio may serve as a predictive biomarker.
May support NLR monitoring for risk stratification after pediatric cardiac surgery; hypothesis-generating and requires prospective validation before practice change.
Background: This study aimed to investigate the incidence and predisposing factors of pulmonary complications in pediatric patients undergoing cardiac surgery and its relationship with the neutrophil-to-lymphocyte ratio (NLR) in the open-heart surgery intensive care unit (ICU-OH) of the Children’s Medical Center Hospital (CMC) in Tehran, Iran. Methods: In this retrospective cohort study, 457 children who underwent open-heart surgery and were transferred to ICU-OH postoperatively were included. Data on age, gender, weight, hospital stay, and risk adjustment for congenital heart surgery (RACHS-1) scores were collected. The incidence of pulmonary complications and its association with NLR were analyzed. Results: The RACHS-1 risk category distribution: Category 1 (15%, n = 65), category 2 (54%, n = 232), category 3 (23%, n = 99), and category 4 (8%, n = 34). Pulmonary complications occurred in 68 children (15.8%), with the highest incidence in infants under one month (34%, n = 18; P < 0.001). Postoperative NLR levels were significantly higher than preoperative levels and were elevated in patients without pulmonary complications, suggesting NLR as a potential predictive factor. Conclusions: The NLR may serve as a useful biomarker for predicting pulmonary complications in pediatric cardiac surgery patients. Further studies are needed to validate these findings and explore underlying mechanisms.
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Farahabadi et al. (2025) conducted a cohort in Pediatric patients undergoing cardiac surgery (n=457). Neutrophil-to-lymphocyte ratio (NLR) was evaluated on Incidence of pulmonary complications. Postoperative neutrophil-to-lymphocyte ratio served as a potential predictor for pulmonary complications, which occurred in 15.8% of pediatric patients following open-heart surgery.
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