Journal of cardiothoracic and vascular anesthesia
May 25, 2026 · via Europe PMC
Perioperative Inflammatory Biomarkers and Early Postoperative Prognosis in Elderly Patients Undergoing Cardiac Surgery.
Kesimci E, Yeşiler Fİ, Fatullayeva N.
AI summary — for doctors, generated from the abstract only
Higher preoperative neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios were associated with poor early outcomes after cardiac surgery in older adults, though predictive performance was moderate.
What was studied
A retrospective single-center cohort of 432 patients aged 65 or older having elective open cardiac surgery (2018 to 2023), evaluating perioperative inflammatory indices against major early cardiac complications.
Key findings
- Poor early prognosis occurred in 22.7%
- Poor prognosis was associated with higher preoperative NLR and PLR, higher EuroSCOREs, longer stays, and higher mortality
- Postoperative indices, particularly at 72 hours, showed stronger associations
- Specific AUC values: specific statistic not fully captured in the abstract
Clinical relevance
These cheap markers may add incremental value to risk assessment but are not strong standalone predictors.
Who should care
Limitations
Retrospective single-center design with exclusions that may introduce selection bias.
Simple blood count ratios modestly flag older heart surgery patients at higher early risk.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Objectives
To evaluate the prognostic value of perioperative inflammatory biomarkers-specifically the systemic immune-inflammation index, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR)-for predicting early postoperative prognosis in elderly patients undergoing elective open cardiac surgery.
Design
Retrospective observational cohort study.
Setting
Single tertiary university hospital.
Participants
A total of 432 patients aged ≥65 years who underwent elective open cardiac surgery between August 2018 and October 2023 were analyzed. Patients with prior thoracic surgery, advanced renal disease, or incomplete preoperative data were excluded from the analysis.
Interventions
No interventional procedures were performed. All patients were managed according to institutional perioperative protocols. Clinical variables and laboratory biomarkers were retrospectively analyzed.
Measurements and main results
Postoperative prognosis was classified as poor or good based on the occurrence of major early postoperative cardiac complications. Poor postoperative prognosis occurred in 98 patients (22.7%). Patients with poor postoperative prognosis exhibited higher preoperative NLR and PLR values, along with higher EuroSCOREs, longer intensive care unit and hospital stays, and increased short-term mortality (all p < 0.05). Among the inflammatory biomarkers assessed, PLR and NLR showed similar predictive performance for poor postoperative prognosis, whereas systemic immune-inflammation index demonstrated limited prognostic value in this cohort. Despite statistical significance, the moderate discriminative ability suggests limited utility for individual risk prediction.
Conclusion
Preoperative PLR and NLR are simple and accessible biomarkers associated with poor early postoperative prognosis in elderly cardiac surgery patients, although their predictive performance is moderate. Postoperative indices, particularly at 72 hours, show stronger associations with adverse outcomes. These markers may offer incremental value when integrated into multimodal perioperative risk assessment.
DOI
10.1053/j.jvca.2026.05.043
PMID
42315413
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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