Wound Inflammatory Cells after Cardiac Surgery and the Patients’ Survival

Abstract

Objective: To find out possible associations between wound inflammatory cell response and the patients’ survival. Background: Several articles have written about the effects of single inflammatory cell types on wound healing but little is known about the interaction of these cells on survival. The methods used in this study have made possible this kind of exploration. Methods: One hundred patients, aged from 41 to 78 years, underwent open heart surgery in the years 1998-1999 and were studied by using the Cellstick device for harvesting wound inflammatory cells during the first 24 hours after surgery. The results of the differential count were computerized by using artificial neural network for obtaining wound inflammatory cell node (WICN). The patients were followed up for sixteen years or to the death. WICN values were compared with the patients’ survival. Results: WICN reflects survival better than any single type of wound inflammatory cells alone (HR = 3.1; p = 0.081 for low/high WICN at 10 year survival). From several clinical characteristics diabetes only predicted shorter survival time (HR = 5.5; p = 0.014 for 10 year survival) better than WICN. Conclusion: These results support the view that regularly timed cell-to-cell ratios in wound inflammation, most often seen as high WICN, reflect beneficial survival. Instead, aberrant counts of inflammatory cells in the wounds lead to low WICN and often to the patients’ shorter survival.