Reply to Letter to the Editor: Preoperative Albumin, Transferrin, and Total Lymphocyte Count as Risk Markers for Postoperative Complications After Total Joint Arthroplasty: A Systematic Review

The aim of this study retrospective cohort was to investigate the prognostic value of preoperative total lymphocyte count in peripheral blood as a predictor of postoperative complications and mortality in cardiac surgery. All adults undergoing cardiopulmonary bypass in 2009. The cohort size was 1 368 patients. Patient characteristics, hospital mortality, postoperative complications, ventilation period, intensive care unit and hospital stay were analysed. Preoperative total lymphocyte count <1 611 cells/L was assotiated with significantly higher mortality by univariate (p<0,0001) and multivariate (p<0,022) analisys. Low preoperative total lymphocyte count was associated with more frequent inotropic support (p<0,001); postoperative heart arrhythmia (p<0,001); hemodialysis-dependent acute renal failure (p<0,001); and a prolonged ventilation period (p=0,001), intensive care unit stay (p<0,001), and hospital stay (p=0,007). Low preoperative total lymphocyte count in peripheral blood is a useful prognostic criterion for evaluation of a complicated postoperative period in cardiosurgical patients.

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Letter to the Editor on “Is Routine Urinary Screening Indicated Prior to Elective Total Joint Arthroplasty? A Systematic Review and Meta-Analysis”

The Journal of Arthroplasty ◽

10.1016/j.arth.2019.05.042 ◽

2019 ◽

Vol 34 (9) ◽

pp. 2193-2194

Author(s):

Axel Probst ◽

Ronny Langenhan

Keyword(s):

Systematic Review ◽

Total Joint Arthroplasty ◽

Meta Analysis ◽

Joint Arthroplasty ◽

Letter To The Editor ◽

Urinary Screening

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TOTAL LYMPHOCYTE COUNT AND SERUM ALBUMIN AS PREDICTORS OF NUTRITIONAL RISK IN SURGICAL PATIENTS

ABCD Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) ◽

10.1590/s0102-67202015000300012 ◽

2015 ◽

Vol 28 (3) ◽

pp. 193-196 ◽

Cited By ~ 12

Author(s):

Naruna Pereira ROCHA ◽

Renata Costa FORTES

Keyword(s):

Postoperative Complications ◽

Nutritional Status ◽

Lymphocyte Count ◽

Global Assessment ◽

Total Lymphocyte Count ◽

Nutritional Risk ◽

Surgical Patients ◽

Subjective Global Assessment ◽

Total Lymphocyte ◽

High Prevalence

Background: Early detection of changes in nutritional status is important for a better approach to the surgical patient. There are several nutritional measures in clinical practice, but there is not a complete method for determining the nutritional status, so, health professionals should only choose the best method to use. Aim: To evaluate the total lymphocyte count and albumin as predictors of identification of nutritional risk in surgical patients. Methods: Prospective longitudinal study was conducted with 69 patients undergoing surgery of the gastrointestinal tract. The assessment of nutritional status was evaluated by objective methods (anthropometry and biochemical tests) and subjective methods (subjective global assessment). Results: All parameters used in the nutritional assessment detected a high prevalence of malnutrition, with the exception of BMI which detected only 7.2% (n=5). The albumin (p=0.01), the total lymphocytes count (p=0.02), the percentage of adequacy of skinfolds (p<0.002) and the subjective global assessment (p<0.001) proved to be useful as predictors of risk of postoperative complications, since the smaller the values of albumin and lymphocyte count and higher the score the subjective global assessment were higher risks of surgical complications. Conclusions: A high prevalence of malnutrition was found, except for BMI. The use of albumin and total lymphocyte count were good predictor for the risk of postoperative complications and when used with other methods of assessing the nutritional status, such as the subjective global assessment and the percentage of adequacy of skinfolds, can be useful for identification of nutritional risk and postoperative complications.

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