{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T15:30:50Z","timestamp":1787758250302,"version":"build-2784847793"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,10]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background:<\/jats:title>\n Post-cardiotomy vasoplegia syndrome (VS) is often linked to an exaggerated inflammatory response to cardiopulmonary bypass (CPB). At the same time, the prognostic role of platelet-leucocyte indices (PLIs) and leucocyte indices (LIs), (platelet-lymphocyte ratio [PLR], systemic immune-inflammation index [SII = platelet \u00d7 neutrophil\/lymphocyte], aggregate index of systemic inflammation [AISI = platelet \u00d7 monocyte \u00d7 neutrophil\/lymphocyte], and neutrophil-lymphocyte ratio [NLR], systemic inflammation response index [SIRI = monocyte \u00d7 neutrophil\/lymphocyte), respectively] has been recently described in diverse inflammatory settings.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n \n The retrospective study was conducted to evaluate the VS predictive performance of PLIs and LIs in 1,045 adult patients undergoing elective cardiac surgery at a tertiary care center. VS was defined by mean blood pressure <60 mmHg, low systemic vascular resistance (SVRI <1,500 dynes.s\/cm 5\/m\n 2<\/jats:sup>\n ), a normal or high CI (>2.5 L\/min\/m\n 2<\/jats:sup>\n ), and a normal or reduced central filling pressure despite high-dose vasopressors.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n About 205 (19.61%) patients developed VS postoperatively. On univariate analysis, age, diabetes, dialysis-dependent renal failure, preoperative congestive heart failure (CHF), the European System for Cardiac Operative Risk Evaluation (EuroSCORE) II, ejection fraction, NLR, PLR, SII, SIRI, AISI, CPB, and aortic cross clamp (ACC) duration, packed red blood cell (PRBC) transfusion, and time-weighted average blood glucose predicted VS. Subsequent to the multivariate analysis, the predictive performance of EuroSCORE II (OR: 3.236; 95% CI: 2.345\u20134.468;\n P<\/jats:italic>\n < 0.001), CHF (OR: 1.04; 95% CI: 1.02\u20131.06;\n P<\/jats:italic>\n = 0.011), SII (OR: 1.09; 95% CI: 1.02\u20131.18;\n P<\/jats:italic>\n = 0.001), AISI (OR: 1.11; 95% CI: 1.05\u20131.17;\n P<\/jats:italic>\n < 0.001), PRBC (OR: 4.747; 95% CI: 2.443\u20139.223;\n P<\/jats:italic>\n < 0.001), ACC time (OR: 1.003; 95% CI: 1.001\u20131.005;\n P<\/jats:italic>\n = 0.004), and CPB time (OR: 1.016; 95% CI: 1.004\u20131.028;\n P<\/jats:italic>\n = 0.001) remained significant. VS predictive cut-offs of SII and AISI were 1,045 1045\u00d710\n 9<\/jats:sup>\n \/mm\n 3<\/jats:sup>\n and 137532\u00d710\n 9<\/jats:sup>\n \/mm\n 3<\/jats:sup>\n , respectively. AISI positively correlated with the postoperative vasoactive-inotropic score (\n R<\/jats:italic>\n = 0.718), lactate (\n R<\/jats:italic>\n = 0.655), mechanical ventilation duration (\n R<\/jats:italic>\n = 0.837), and ICU stay (\n R<\/jats:italic>\n = 0.757).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n Preoperative elevated SII and AISI emerged as independent predictors of post-cardiotomy VS.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/aca.aca_54_21","type":"journal-article","created":{"date-parts":[[2022,10,7]],"date-time":"2022-10-07T10:50:57Z","timestamp":1665139857000},"page":"414-421","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":19,"title":["VASOplegia is Predicted by Preoperative Platelet-LEucocyte conGlomerate Indices in Cardiac Surgery (VASOPLEGICS)"],"prefix":"10.4103","volume":"25","author":[{"given":"Rohan","family":"Magoon","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramesh C.","family":"Kashav","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iti","family":"Shri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Souvik","family":"Dey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashish","family":"Walian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasvinder K.","family":"Kohli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-5-20240901","doi-asserted-by":"crossref","first-page":"2131","DOI":"10.1161\/01.ATV.0000095974.95122.EC","article-title":"Platelets in inflammation and thrombosis","volume":"23","author":"Wagner","year":"2003","journal-title":"Arterioscler Thromb Vasc Biol"},{"key":"R2-5-20240901","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1016\/j.jsha.2015.02.004","article-title":"The platelet-to-lymphocyte ratio as a predictor of all-cause mortality in patients with coronary artery disease undergoing elective percutaneous coronary intervention and stent implantation","volume":"27","author":"Osadnik","year":"2015","journal-title":"J Saudi Heart Assoc"},{"key":"R3-5-20240901","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1159\/000453614","article-title":"Association of preoperative platelet-to lymphocyte ratio with atrial fibrillation after coronary artery bypass graft surgery","volume":"26","author":"Gungor","year":"2017","journal-title":"Med Princ Pract"},{"key":"R4-5-20240901","first-page":"57","article-title":"Systemic immune-inflammation index predicts mortality in infective endocarditis","volume":"32","author":"Agus","year":"2020","journal-title":"J Saudi Heart Assoc"},{"key":"R5-5-20240901","doi-asserted-by":"crossref","first-page":"2001","DOI":"10.1053\/j.jvca.2020.02.012","article-title":"Evolving spectrum of prognostic inflammatory markers in infective endocarditis","volume":"34","author":"Magoon","year":"2020","journal-title":"J Cardiothorac Vasc Anesth"},{"key":"R6-5-20240901","doi-asserted-by":"crossref","first-page":"5725","DOI":"10.3390\/molecules25235725","article-title":"The systemic inflammation index on admission predicts in-hospital mortality in COVID-19 patients","volume":"25","author":"Fois","year":"2020","journal-title":"Molecules"},{"key":"R7-5-20240901","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1053\/j.jvca.2019.07.003","article-title":"Endothelial glycocalyx and cardiac surgery: Newer Insights","volume":"34","author":"Magoon","year":"2020","journal-title":"J Cardiothorac Vasc Anesth"},{"key":"R8-5-20240901","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1053\/j.jvca.2019.08.001","article-title":"Micro RNAs in cardiac surgery: Novel molecular signatures!","volume":"34","author":"Magoon","year":"2020","journal-title":"J Cardiothorac Vasc Anesth"},{"key":"R9-5-20240901","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1016\/j.ejcts.2003.11.032","article-title":"Risk factors and outcomes for \u201cvasoplegia syndrome\u201d following cardiac transplantation","volume":"25","author":"Byrne","year":"2004","journal-title":"Eur J Cardiothorac Surg"},{"key":"R10-5-20240901","first-page":"619","article-title":"Vasoplegic syndrome after open heart surgery","volume":"39","author":"Gomes","year":"1998","journal-title":"J Cardiovasc Surg"},{"key":"R11-5-20240901","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1111\/j.1540-8191.2000.tb00470.x","article-title":"Low systemic vascular resistance after cardiopulmonary bypass: Incidence, etiology, and clinical importance","volume":"15","author":"Carrel","year":"2000","journal-title":"J Card Surg"},{"key":"R12-5-20240901","doi-asserted-by":"crossref","first-page":"1664","DOI":"10.1161\/CIRCULATIONAHA.108.814533","article-title":"Early on-cardiopulmonary bypass hypotension and other factors associated with vasoplegic syndrome","volume":"120","author":"Levin","year":"2009","journal-title":"Circulation"},{"key":"R13-5-20240901","first-page":"277","article-title":"Endothelial cell injury in cardiovascular surgery: The systemic inflammatory-response","volume":"63","author":"Boyle","year":"1997","journal-title":"Ann Thorac Surg"},{"key":"R14-5-20240901","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1007\/s11748-017-0789-6","article-title":"Risk assessment and outcomes of vasoplegia after cardiac surgery","volume":"65","author":"Tsiouris","year":"2017","journal-title":"Gen Thorac Cardiovasc Surg"},{"key":"R15-5-20240901","doi-asserted-by":"crossref","first-page":"S211","DOI":"10.1016\/j.healun.2019.01.514","article-title":"Elevated pre-transplant neutrophil to lymphocyte ratio is associated with increased vasoplegia syndrome in cardiac transplantation","volume":"38","author":"Ahmed","year":"2019","journal-title":"J Heart Lung Transplant"},{"key":"R16-5-20240901","doi-asserted-by":"crossref","first-page":"2397","DOI":"10.1053\/j.jvca.2020.09.092","article-title":"Systemic immune-inflammation index predicts poor outcome after elective off-pump CABG: A retrospective, single-center study","volume":"35","author":"Dey","year":"2021","journal-title":"J Cardiothorac Vasc Anesth"},{"key":"R17-5-20240901","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1007\/s00540-020-02849-w","article-title":"Intraoperative hyperglycemia in patients with an elevated preoperative C-reactive protein level may increase the risk of acute kidney injury after cardiac surgery","volume":"35","author":"Lee","year":"2021","journal-title":"J Anesth"},{"key":"R18-5-20240901","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1097\/PCC.0b013e3181b806fc","article-title":"Vasoactive-inotropic score as a predictor of morbidity and mortality in infants after cardiopulmonary bypass","volume":"11","author":"Gaies","year":"2010","journal-title":"Pediatr Crit Care Med"},{"key":"R19-5-20240901","doi-asserted-by":"crossref","first-page":"1013","DOI":"10.1053\/j.jvca.2017.10.032","article-title":"Vasoplegia after cardiovascular procedures-pathophysiology and targeted therapy","volume":"32","author":"Shaefi","year":"2018","journal-title":"J Cardiothorac Vasc Anesth"},{"key":"R20-5-20240901","doi-asserted-by":"crossref","first-page":"838","DOI":"10.1093\/icvts\/ivy352","article-title":"Risk factors for vasoplegia after cardiac surgery: A meta-analysis","volume":"28","author":"Dayan","year":"2019","journal-title":"Interact Cardiovasc Thorac Surg"},{"key":"R21-5-20240901","doi-asserted-by":"crossref","first-page":"3151","DOI":"10.1093\/ehjci\/ehaa946.3151","article-title":"The systemic immune-inflammation index is associated with early postoperative morbidity and mortality following cardiac surgery","volume":"41","author":"Rosalia","year":"2020","journal-title":"Eur Heart J"},{"key":"R22-5-20240901","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1016\/j.ajem.2020.12.070","article-title":"Hematological inflammatory prognostication in COVID-19: Points to ponder!","volume":"45","author":"Magoon","year":"2021","journal-title":"Am J Emerg Med"},{"key":"R23-5-20240901","doi-asserted-by":"crossref","first-page":"770","DOI":"10.1016\/j.athoracsur.2017.09.039","article-title":"Characterizing predictors and severity of vasoplegia syndrome after heart transplantation","volume":"105","author":"Chan","year":"2018","journal-title":"Ann Thorac Surg"},{"key":"R24-5-20240901","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1002\/JLB.4RU0418-161R","article-title":"Inducible nitric oxide synthase: An asset to neutrophils","volume":"105","author":"Saini","year":"2019","journal-title":"J Leukoc Biol"},{"key":"R25-5-20240901","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1182\/blood.V69.1.324.324","article-title":"Human neutrophil degranulation during extracorporeal circulation","volume":"69","author":"Wachtfogel","year":"1987","journal-title":"Blood"},{"key":"R26-5-20240901","doi-asserted-by":"crossref","first-page":"812","DOI":"10.1016\/j.athoracsur.2011.04.020","article-title":"Transfusion increases the risk for vasoplegia after cardiac operations","volume":"92","author":"Alfirevic","year":"2011","journal-title":"Ann Thorac Surg"},{"key":"R27-5-20240901","doi-asserted-by":"crossref","first-page":"1679","DOI":"10.1111\/jocs.14297","article-title":"Vasoplegic syndrome after cardiac surgery: Better the devil you know!","volume":"34","author":"Magoon","year":"2019","journal-title":"J Card Surg"},{"key":"R28-5-20240901","doi-asserted-by":"crossref","first-page":"e460","DOI":"10.1016\/j.bja.2020.08.042","article-title":"Safeguarding anaesthesia research from spin?","volume":"125","author":"Magoon","year":"2020","journal-title":"Br J Anaesth"}],"container-title":["Annals of Cardiac Anaesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/aca.aca_54_21","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T15:11:03Z","timestamp":1787757063000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/aca.aca_54_21"}},"subtitle":["A Retrospective Single-Center Study"],"short-title":[],"issued":{"date-parts":[[2022,10]]},"references-count":28,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.4103\/aca.aca_54_21","relation":{},"ISSN":["0971-9784"],"issn-type":[{"value":"0971-9784","type":"print"}],"subject":[],"published":{"date-parts":[[2022,10]]}}}