Postoperative risk stratification in children with Down Syndrome undergoing repair of complete atrioventricular septal defect (CAVSD) remains challenging. The leuko-glycemic index (LGI), derived from leukocyte count and blood glucose, has not been previously validated in this population. This ambidirectional cohort study published in the Journal of Cardiothoracic and Vascular Anesthesia assessed the prognostic value of LGI for adverse postoperative outcomes

A total of 110 infants with Down syndrome undergoing primary intracardiac repair of CAVSD at a single tertiary cardiac center were enrolled; 104 completed follow-up and were included in the final analysis. All patients received standardized perioperative anesthesia and hemodynamic management. The primary outcome assessed composite postoperative events, including prolonged mechanical ventilation (PMV), defined as ≥24 hours.

Postoperative LGI was significantly associated with PMV (p=0.042). An LGI cutoff >1,640.16 predicted PMV, with an area under the receiver operating characteristic curve (AUC) of 0.659 (95% confidence interval [CI] 0.548–0.771), sensitivity 47.50%, and specificity 81.25% (p=0.005). An LGI cutoff >2,657.88 differentiated patients who developed renal failure from those who did not, with an AUC of 0.723 (p=0.019).

Postoperative LGI was associated with ventilation duration and renal outcomes. Higher LGI values were associated with prolonged ventilation and postoperative renal failure.