Impact of Naples Prognostic Score on the development of surgical reexploration in open heart surgery patients

Year 2024, Volume: 51 Issue: 2, 183 - 190, 14.06.2024

Mehmet Karaçalılar İrfan Dinler Nurhayat İnci Sinan Göçer , Mahir Kuyumcu , Mehmet Özbek

https://doi.org/10.5798/dicletip.1501104

Abstract

Background: Significant and minor perioperative bleeding is common in patients undergoing open heart surgery. Perioperative bleeding has become an important prognostic indicator. Naples Prognostic Score (NPS); It is an effective tool that can be used to detect malnutrition, calculated according to serum albumin level, total cholesterol amount, neutrophil-lymphocyte ratio (NLR), and lymphocyte-monocyte ratio (LMR). In our study,we were planned to evaluate malnutrition and show its negative effects by using the NPS score in patients undergoing open heart surgery.
Methods and Results: For the study, a total of 2071 patients who underwent open heart surgery were examined in detail randomly, sequentially and retrospectively. A total of 1825 patients were examined in detail after the patients covering the exclusion criteria were removed. It was determined that a total of 73 patients underwent surgical reexploration. In 53 (4.3%) of the patients with coronary artery bypass surgery, in 11 (3%) of the patients with heart valve surgery, in 8 (4.7%) of the patients with heart valve surgery combined with coronary artery bypass surgery, It was determined that surgical reexploration was performed in 1 (2.8%) of the other procedures. Multivariate regression model; showed that being in the high NPS score group, increasing age, and female gender were independent determinants of the need for surgical reexploration. It was determined that the need for reexploration was observed in the group with higher NPS score (median 3.18 vs 2.69, p<0.001).
Conclusion: A high NPS score can provide very important prognostic information. Patients in the high NPS score group required surgical reexploration more frequently.

Keywords

Open Heart Surgey, NPS Score, surgical reexploration

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