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Corresponding Author

Mohamed, Marwa

Document Type

Original Article

Abstract

Background: Cardiac surgery has long been recognized to cause an inflammatory response. When an inflammatory reaction is triggered, the white blood cell (WBC) count rises, which is known as leukocytosis. We aimed to describe the association between post-operative leukocytosis and baseline characteristics, operative characteristics, and postoperative outcomes. Patients and Methods: This was a hospital-based, single-center, observational study, conducted at Prince Sultan Cardiac Center, Najran, KSA, during the period from September 2021 to May 2022. A total of 150 patients who underwent coronary artery bypass graft (CABG) Surgery and/or valve surgery within the Cardiac surgery department during the study period, were enrolled in this study. Results: The incidence of post-operative leukocytosis was (19.33%). Patients with post-operative leukocytosis were elder than those with no post-operative leukocytosis and associated with a higher proportion of severe obesity (p=0.001), DM (p=0.025), pulmonary diseases (p < 0.001), dialysis (p < 0.001), smoking (p < 0.001), and prior ICU admission (p < 0.001). The multivariate analysis showed that the independent significant predictors of post-operative leukocytosis were BMI >37 (OR= 5.79, p=0.014), DM (OR= 13.98, p=0.001), HTN (OR= 0.018, p < 0.001), dialysis (OR= 17.26, p=0.012), prior ICU (OR= 9.40, p=0.001), and prior Coronary Angio (OR= 4.35, p=0.018). Conclusion: The current evidence demonstrated that CBP was associated with a 19% incidence of post-operative leukocytosis. BMI >37, DM, HTN, dialysis, prior ICU, prior coronary angio, and left main disease ≥50% were significant independent predictors of postoperative leukocytosis. Improving process-of-care elements such as antibiotic optimal timing while taking into account patient-specific risk factors reduced the risk of postoperative leukocytosis.

Keywords

leukocytosis; WBC; prophylactic antibiotics; CBP; SSI

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