International Journal of General Medicine (Oct 2021)

Preoperative Glucose-to-Lymphocyte Ratio is an Independent Predictor for Acute Kidney Injury After Cardiac Surgery in Patients in Intensive Care Unit

  • Li L,
  • Zou G,
  • Liu J

Journal volume & issue
Vol. Volume 14
pp. 6529 – 6537

Abstract

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Lu Li,1,* Gaorui Zou,2,* Jie Liu1 1Department of Nephrology, The First People’s Hospital of Jiangxia District, Wuhan, 430299, People’s Republic of China; 2Department of Anesthesiology, Wuhan No. 1 Hospital, Wuhan, 430022, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jie LiuDepartment of Nephrology, The First People’s Hospital of Jiangxia District, No. 1 of Cultural Avenue, Wuhan, 430299, People’s Republic of ChinaTel +86 27-87958740Email [email protected]: We aimed to investigate the association between preoperative glucose-to-lymphocyte ratio (GLR) and cardiac surgery associated with acute kidney injury (CSA-AKI) in patients in the intensive care unit (ICU).Methods: The Medical Information Mart for Intensive Care IV (MIMIC-IV version 1.0) database was used to identify adults’ patients who performed cardiac surgery during ICU stay. The primary outcome was the development of AKI based on the KDIGO criteria. Multivariable logistic regression was applied to investigate the association between GLR and clinical outcomes, and propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were also used to validate our findings.Results: The optimal cut-off value for GLR was 1.28. Among the 7181 patients who conducted cardiac surgery, 2072 high-GLR group (≥ 1.28) patients and 2072 low-GLR group (< 1.28) patients, had similar propensity scores were included in this study. After matching, the high-GLR group had a significantly higher incidence of AKI (odds ratio, OR, 3.28, 95% confidence index, 95% CI, 2.81– 3.84, P < 0.001) even after adjustment for confounding factors. Moreover, the performance of GLR was superior to that of SOFA scores and GLR plus clinical model could add more net benefit for CSA-AKI than clinical model alone.Conclusion: Preoperative GLR could serve as a good predictor for CSA-AKI in patients in ICU.Keywords: glucose to lymphocyte, cardiac surgery, acute kidney injury, Medical Information Mart for Intensive Care, propensity score matching

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