Relationship between normal preoperative white blood cell count and major adverse events after endovascular repair for abdominal aortic aneurysm: results of a pilot study - 18/04/17

: (Professor of Anesthesiology), George Kouvelos, MD, MSc, PhD b, Petros Tzimas, MD, PhD a : (Assistant Professor of Anesthesiology), Eleni Laou, MD a, Vasilios Bouris, MD b, George Papadopoulos, MD, PhD a : (Professor of Anesthesiology), Miltiadis Matsagkas, MD, PhD b : (Professor of Vascular Surgery)Abstract |
Study objective |
To examine the association between preoperative white blood cell (WBC) count within the reference range and major adverse events (MAEs) following endovascular repair of abdominal aortic aneurysms (AAA).
Design |
Prospective observational study.
Setting |
Vascular surgery clinic in a tertiary university hospital.
Patients |
One hundred fifty-three consecutive patients.
Intervention |
Endovascular repair of AAA.
Measurements |
All patients had normal preoperative WBC count (3.5-10.3 K/μL). Postoperative MAE was defined as death, stroke, and myocardial infarction. The prognostic value of preoperative WBC was determined by receiver operating characteristic curves, whereas χ2 test and Cochran-Armitage trend test were used to assess the association between MAE and different values of WBC.
Main results |
A preoperative WBC cutoff value of 7.3 Κ/μL could predict MAE with 62% sensitivity and 62% specificity (area under the curve, 0.62). Patients with higher preoperative WBC experienced more events compared with patients with lower values (P=.027). A linear relationship was observed between an increasing preoperative WBC count within the reference range and the risk of postoperative events (P=.004). Logistic regression analysis showed that preoperative normal WBC count was an independent predictor of MAE and revealed that for every 1-K/μL increase, patients had a 32.8% increase in their relative odds of developing postoperative MAE (P=.035).
Conclusions |
This pilot study demonstrates a linear correlation between an increasing preoperative WBC count within the reference range and an increased risk for postoperative MAEs following endovascular repair for AAA. Identification of high-risk patients at an early stage by using WBC count could prove useful in implementing measures to improve their clinical outcome.
Le texte complet de cet article est disponible en PDF.Highlights |
• | A study on the association of WBC count within reference range and MAE after EVAR was performed. |
• | One hundred fifty-three patients were included. |
• | Preoperative normal WBC count was an independent predictor of MAE. |
Keywords : Abdominal aortic aneurysm, Adverse events, Endovascular, Prediction, White blood cell count
Plan
| ☆ | Funding: none. |
| ☆☆ | Conflict of interest: none. |
Vol 36
P. 201-205 - février 2017 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?
