Abstract 13101: Pre-Operative Complete Blood Count As a Predictor of Outcomes Prior to Isolated, First Time Coronary Artery Bypass Grafting Surgery
Purpose: The objective of this study was to assess the inter-relationship of preoperative complete blood count (CBC) components (white blood cells (WBC), hemoglobin, platelets) and their predictive value for outcomes following CABG.
Methods: Outcome and CBC data were prospectively collected on 3,000 isolated CABG patients from 2005 to 2009. Logistic regression was used to predict major adverse cardiac events (MACE) and operative mortality after adjusting for age, sex, and preoperative comorbidities. Patients were divided into normal hemoglobin and anemic (men=<13g/dL, women=<12g/dL), with subgroups based on the presence of low platelets (<140,000/microliter) or high WBC (>10,800/microliter).
Results: Admission anemia was noted in 977 patients (mean=11.3g/dL +/− 1.3), 507 had elevated WBC (mean=14.8x103 +/− 5.7), and 203 patients had low platelet counts (mean=113.9x103 +/− 20.5). Unfavorable levels of the CBC markers as a group were predictive of greater operative mortality and greater MACE (See Table). Only admission platelet level was independently predictive of operative mortality, whereas all three CBC markers were independently predictive of MACE (See Table). In combination, patients with anemia and low platelets had significantly higher risk for operative mortality as compared to those with normal CBC (OR=5.02, p<0.01). Also, the combination of anemia with high WBC had a greater risk of MACE (OR=4.98, p<0.001) as did anemia with low platelets (OR=3.20, p<0.05).
Conclusions: The CBC can be utilized as a marker for high risk patients going for CABG. A thorough evaluation of the CBC is essential, as each abnormal component confers risk for adverse outcome, with a cumulative effect for multiple abnormalities. Patients with anemia, low platelets, and high WBC are at increased risk for MACE, whereas those with low platelets are at increased risk for operative mortality. Abnormal values must be addressed and if possible corrected to improve patient outcomes.
- © 2010 by American Heart Association, Inc.