Inflammatory indices predict poor early outcomes after tricuspid valve surgery: A retrospective cohort study

This study investigated the prognostic value of neutrophil count, neutrophil-to-lymphocyte ratio (NLR), and systemic immune-inflammation index (SII) in predicting poor early outcomes, including in-hospital mortality and complications, after tricuspid valve replacement (TVR). We retrospectively analyzed 76 patients who underwent TVR between 2014 and 2024 at a tertiary cardiovascular surgery center. Preoperative and postoperative neutrophil counts, NLR, and SII were calculated from blood samples. Patients were divided into survivor and non-survivor groups. Receiver operating characteristic (ROC) curve analysis and Cox regression models were used to evaluate the predictors of in-hospital mortality and complications. The in-hospital mortality was 15.8%. The preoperative neutrophil count, NLR, and SII values were significantly higher in the non-survivors (P < .05). ROC analysis showed that preoperative NLR (>3.2) and SII (>580), as well as postoperative NLR (>3.55) and SII (>805), predicted mortality with high sensitivity and specificity. Cox regression analysis revealed that preoperative neutrophil count (hazard ratio [HR] = 26.06, P = .005), NLR (HR = 23.03, P = .006), and SII (HR = 1.009, P = .018) were independent predictors of mortality. Prolonged intensive care unit and hospital stays and chronic obstructive pulmonary disease were also significantly associated with poor outcomes. Neutrophil count, NLR, and SII were strong independent markers for predicting early postoperative mortality and complications following TVR. These easily accessible inflammatory indices may enhance the risk stratification and postoperative monitoring during cardiac surgery.