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Tetralogy of Fallot (ToF) were cyanotic congenital heart disease with chronic hypoxia which increases the risk of exacerbated inflammatory response in ToF primary repair. Various studies have recently shown inflammatory biomarkers to predict morbidity and mortality in hypoxemic patients, but they are not readily available and expensive.This study aims to compare the prognostic value of neutrophil-lymphocyte ratio (NLR), absolute lymphocyte count (ALC), and thrombocyte-lymphocyte ratio (TLR) in predicting ToF primary repair outcomes. This was a retrospective observational study on ToF primary repair in National Cardiovascular Center Harapan Kita between Januari 2020 until December 2022. Preoperative NLR, ALC, and TLR were derived from blood test obtained <14 days before surgery. The primary endpoints were redo surgery, 30-day mortality, and complications. The secondary endpoints were hospital length of stay (HLOS) and postoperative LOS.
This was a retrospective observational study on tetralogy of Fallot (ToF) primary repair in National Cardiovascular Center Harapan Kita between Januari 2020 until December 2022. The preoperative demographic data included were patients' gender, age, weight, oxygen saturation, and associated diagnosis other than ToF. The preoperative data of complete blood count and differential count must be tested from the most recent peripheral blood samples taken no later than 14 days before the surgery. The data obtained were the number of days of the most recent blood test including the leukocyte count, percentage neutrophil, percentage and absolute lymphocyte count, thrombocyte count, as well as the derived variables such as neutrophil lymphocyte ratio (NLR) ratio and thrombocyte lymphocyte ratio (TLR). The intraoperative data included were the use of cardiopulmonary bypass (CPB), CPB time, aortic cross-clamp (AOX) time, and the total duration of surgery. Patients were evaluated and followed-up for any complications and postoperative mortality during the same hospital stay until discharge. Patients were then followed up for any cause of mortality within 30 days postoperative.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| ToF primary repair | Patients who underwent ToF primary repair from January 2020 until December 2022 |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| ToF primary repair | Procedure | ToF primary repair for patients with ToF |
|
| Measure | Description | Time Frame |
|---|---|---|
| Number of Patients Requiring Redo surgery | Redo surgery was defined as additional or corrective surgery after the initial primary ToF repair within the same hospital admission. | From the initial primary ToF until the discharge of the patients or until 2 weeks after the operation, whichever came first |
| Mortality | Mortality intraoperative or postoperative | Until 30 days postoperative |
| Complications (categorized as mild, moderate, severe) | Complication was defined as any adverse events that arised during the operation or postoperative until the discharge of the patient. | From the initial primary ToF until the discharge of the patients or until 2 weeks after the operation, whichever came first |
| Measure | Description | Time Frame |
|---|---|---|
| Hospital Length of Stay | Hospital length of stay (HLOS) was defined as the duration of stay in the hospital from the initial admission to discharge. | From the initial primary ToF until the discharge of the patients or until 12 weeks after the operation, whichever came first |
| Postoperative Length of Stay |
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Inclusion Criteria:
Exclusion Criteria:
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patients who underwent ToF primary repair in National Cardiovascular Center Harapan Kita between Januari 2020 until December 2022
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| Name | Affiliation | Role |
|---|---|---|
| Sisca N Siagian, MD | National CCHK | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| National Cardiovascular Center Harapan Kita Jakarta Indonesia | Jakarta | Indonesia |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 40538915 | Derived | Siagian SN, Christianto C. Prognostic value of neutrophil-lymphocyte ratio, absolute lymphocyte count, and thrombocyte-lymphocyte ratio in predicting the outcomes of tetralogy of fallot primary repair. Front Cardiovasc Med. 2025 Jun 5;12:1489242. doi: 10.3389/fcvm.2025.1489242. eCollection 2025. |
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At the moment, the investigators have no plan to share the whole participant data. However, if it is needed, the investigators will
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Longer postoperative LOS was defined as hospitalization of more than 5 days from the period of surgery until postoperative discharge (based on our center). |
| From the initial primary ToF until the discharge of the patients or until 12 weeks after the operation, whichever came first |
| ID | Term |
|---|---|
| D006330 | Heart Defects, Congenital |
| D013771 | Tetralogy of Fallot |
| ID | Term |
|---|---|
| D018376 | Cardiovascular Abnormalities |
| D002318 | Cardiovascular Diseases |
| D006331 | Heart Diseases |
| D000013 | Congenital Abnormalities |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
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