ArticlePloS one2017
Preoperative asymptomatic leukocytosis and postoperative outcome in cardiac surgery patients.
Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.
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Who cites it
25 citing papers in PubMed, 48 citations in OpenAlex.
- Risk assessment in cardiac surgery: Exploring machine learning and laboratory indices as adjunctive tools.PloS one · 2026Article
- Predictors of Postoperative Pneumonia Following Anatomical Lung Resections in Thoracic Surgery.Journal of clinical medicine · 2025Article
- Machine learning in predicting preoperative intra-aortic balloon pump use in patients undergoing coronary artery bypass grafting.Journal of cardiothoracic surgery · 2025Article
- Leukopenia and leukocytosis are associated with early postoperative complications following aseptic revision total shoulder arthroplasty.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Article
- Predicting Mortality Following Odontoid Fracture Fixation in Elderly Patients: CAADS-16 Score.Global spine journal · 2025Article
- Risk Factors of Prolonged Mechanical Ventilation in Post Coronary Artery Bypass Graft Patients: A Scoping Review.Journal of multidisciplinary healthcare · 2025Review
- Preoperative Hemoglobin Level Predicts Surgical Site Infections in Trauma Orthopedic Surgery: A Cohort Study.Journal of tropical medicine · 2025Article
- Risk factors for the occurrence of infection in patients with oral squamous cell carcinoma after restorative reconstruction and its impact on recurrence and quality of life: a retrospective cohort study.Translational cancer research · 2023Article
- Abnormal preoperative leukocyte counts and postoperative complications following total shoulder arthroplasty.JSES international · 2023Article
- Incidence and peri-operative risk factors for development of acute kidney injury in patients after cardiac surgery: A prospective observational study.World journal of clinical cases · 2023Article
- Perioperative Risk Factors for Post-operative Pneumonia after Type A Acute Aortic Dissection Surgery.Current medical science · 2023Article
- Identification of risk factors for infection after mitral valve surgery through machine learning approaches.Frontiers in cardiovascular medicine · 2023Article
- The role of preoperative albumin and white blood cell count in surgical site infections following whipple surgery.Scientific reports · 2022Article
- Hematopoietic Stem Cells in Wound Healing Response.Advances in wound care · 2022Article
- Predictive model of postoperative pneumonia after neoadjuvant immunochemotherapy for esophageal cancer.Journal of gastrointestinal oncology · 2022Article
- A Novel Nomogram for Predicting Post-Operative Sepsis for Patients With Solitary, Unilateral and Proximal Ureteral Stones After Treatment Using Percutaneous Nephrolithotomy or Flexible Ureteroscopy.Frontiers in surgery · 2022Article
- Article
- Impact of preoperative nasopharyngeal cultures on surgical site infection after open heart surgery.JTCVS open · 2021Article
- Development and validation of risk prediction score for incisional surgical site infection after appendectomy.Updates in surgery · 2021Article
- Postoperative Neutrophil-to-Lymphocyte Ratio Is Associated with Mortality in Adult Patients After Cardiopulmonary Bypass Surgery: A Cohort Study.Medical science monitor : international medical journal of experimental and clinical research · 2021Article
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDespite showing a prognostic value in general surgical patients, preoperative asymptomatic elevated white blood cell (WBC) count is not considered a risk factor for cardiac surgery. Whereas there is sporadic evidence of its value as a preoperative risk marker, it has not been looked at methodically as a specific index of outcome during cardiac surgery. Using a national database we sought to determine the relationship between preoperative WBC count and postoperative outcome in cardiac surgical patients.
methodsCardiac surgeries were extracted from the 2007-2013 American College of Surgeons National Surgical Quality Improvement Program database. Leukocytosis was defined by a preoperative WBC count greater than 11,000 cells/μL. A univariate analysis compared the incidence of adverse outcomes for patients with and without leukocytosis. A multivariate logistic regression model was constructed in order to test whether leukocytosis was an independent predictor of morbidity and mortality.
resultsOut of a total of 10,979 cardiac surgery patients 863 (7.8%) had preoperative leukocytosis. On univariate analysis, patients with leukocytosis experienced greater incidences of 30-day mortality, wound complications, and medical complications. Wound complications included surgical site infection as well as wound dehiscence. The medical complications included all other non-surgical causes of increased morbidity and infection leading to urinary tract infection, pneumonia, ventilator dependence, sepsis and septic shock. After stepwise model adjustment, leukocytosis was a strong predictor of medical complications (OR 1.22, 95% CI: 1.09-1.36, p = 0.002) with c-statistic of 0.667. However, after stepwise model adjustment leukocytosis was not a significant predictor of 30-day mortality and wound complications.
conclusionPreoperative leukocytosis is associated with adverse postoperative outcome after cardiac surgery and is an independent predictor of infection-related postoperative complications.
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