Delta Neutrophil Index in Coronary Artery Bypass Surgery: An Innovation in Postoperative Mortality Assessment

Abstract a. Background: Recently, the role of inflammatory markers in assessing the severity of CAD in the early stages has garnered interest. Currently, there are no specific inflammatory biomarkers routinely used for predicting postoperative mortality in patients undergoing coronary artery bypass grafting (CABG). In this study, we evaluated the significance of postoperative DNI as a prognostic marker for early mortality in patients undergoing coronary artery bypass grafting (CABG). b. Aims: The aim of this study is to determine the significance of the delta neutrophil index (DNI), which reflects the proportion of immature granulocytes, as a prognostic marker for early postoperative mortality in coronary artery bypass grafting (CABG). c. Methods: This rigorously designed retrospective cohort study, conducted at a high-volume tertiary care center specializing in cardiovascular surgery, included a robust patient cohort to ensure comprehensive data analysis and reliable conclusions. The study included a consecutive series of 446 patients who underwent coronary artery bypass grafting (CABG) between January 1, 2022, and August 1, 2023. d. Results: Mortality was found to be associated with Pre-DNI (p < 0.05). A 1-unit increase in Pre-DNI measurement was associated with a 2.61-fold (95% Confidence Interval: 1.54–4.45) increase in the risk of death. Additionally, mortality was also associated with Post-DNI (p < 0.05). A 1-unit increase in Post-DNI measurement was associated with a 10.21-fold (95% Confidence Interval: 5.08–20.05) increase in the risk of death. e. Conclusions: This study unequivocally establishes that elevated DNI values serve as potent independent predictors of postoperative mortality, underscoring the clinical utility of DNI as a key component in the perioperative risk stratification for CABG patients. Both preoperative and postoperative DNI were significantly associated with mortality, highlighting the valuable role of DNI in risk assessment necessary for perioperative and postoperative management. This highlights the dual utility of DNI in not only predicting but also monitoring patient outcomes throughout the perioperative period. Incorporating DNI into routine clinical practice could provide a more personalized approach to postoperative care, potentially improving patient survival and reducing complication rates in CABG surgery.