Analisa Durasi Cardiopulmonary Bypass terhadap Nilai Rasio Neutrofil Limfosit Pasien Rawatan ICU Bedah Jantung Paska Coronary Artery Bypass Grafting di Rsup Haji Adam Malik Medan

Abstract

Background: The aim of this study was to investigate the prognostic role of the neutrophil to lymphocyte ratio (NLR) in patients undergoing Coronary Artery Bypass Grafting (CABG) with cardiopulmonary bypass (CPB). Methods: A retrospective cohort study of 91 patients who underwent CABG with CPB in the Cardiac Surgical ICU , Haji Adam Malik Hospital, Medan from January 2019 to Desember 2019 was conducted. All perioperative clinical data, including CPB time, Aortic cross clamp (AOX) time, neutrophil count, lymphocyte count, were collected retrospectively. Retrospective study was performed to compared NLR in patients with prolonged CPB Time. The prognostic value of NLR and its association duration of intensive care unit (ICU) stay were analyzed. Results: Leucocytes count, NLR, and CRP were significantly increased post-operative compared with pre-operative (p < 0.05). The increased post-operative levels of NLR were significantly associated with prolonged CPB time (p < 0.05). Strong correlation (r: 0.505) between CPB time and NLR were reported. The increased post-operative levels of NLR were also significantly associated with prolonged post-operative cardiac ICU stay (p < 0.05). Bivariate linear correlation analysis revealed that elevated NLR displayed a significant independent association with duration of an ICU stay. Conclusion: Increased post-operative NLR followed by cardiac surgery with prolong CPB time in CABG patients was associated with a longer duration of an ICU stay.

Latar Belakang: Tujuan penelitian ini adalah untuk mengetahui hubungan nilai rasio neutrofil limfosit (NLR) pada pasien yang menjalani Coronary Artery Bypass Grafting (CABG) dengan cardiopulmonary bypass (CPB). Metode: Telah dilakukan penelitian kohort retrospektif terhadap 91 pasien yang menjalani CABG dengan CPB di ICU Bedah Jantung, RSUP Haji Adam Malik, Medan dari Januari 2019 hingga Desember 2019. Semua data klinis perioperatif, termasuk waktu CPB, waktu Aortic cross clamp (AOX), jumlah neutrofil, jumlah limfosit, dikumpulkan secara retrospektif. Studi retrospektif dilakukan untuk mengetahui hubungan NLR pada pasien dengan durasi CPB Time. Pada penelitian ini nilai korelasi NLR dan durasi perawatan intensif di ICU dianalisis. Hasil: Jumlah leukosit, NLR, dan CRP meningkat secara signifikan pasca operasi dibandingkan dengan pra operasi (p <0,05). Kadar NLR pasca operasi yang meningkat secara signifikan terkait dengan waktu CPB yang berkepanjangan (p <0,05). Korelasi kuat (r: 0,505) antara waktu CPB dan NLR dilaporkan. Kadar NLR pasca operasi yang meningkat juga secara signifikan terkait dengan durasi rawatan ICU Jantung pasca operasi yang berkepanjangan (p <0,05). Analisis bivariat mengungkapkan bahwa peningkatan NLR berkorelasi positif dengan durasi rawat di ICU. Kesimpulan: Peningkatan NLR pasca operasi diikuti dengan operasi jantung dengan waktu CPB yang memanjang pada pasien CABG dikaitkan dengan durasi rawat ICU yang lebih lama.