Investigation of Systemic Immune Inflammatory Index and Prognostic Nutritional Index in Prediction of Major Adverse Cardiovascular and Cerebral Events Occurring After Coronary Artery Bypass Operations

Year 2021, , 263 - 269, 31.12.2021

Mustafa Abanoz , Mesut Engin

https://doi.org/10.30565/medalanya.929006

Cited By: 3

Abstract

Aim: The most valuable treatment method for coronary artery disease is coronary artery bypass graft (CABG) surgery. Major cardiovascular and cerebral events (MACCE) are important challenges, and it is particularly important to reveal possible risk factors in this regard. In this study, we aimed to investigate the predictive areas of the prognostic nutritional index (PNI) and the systemic immune inflammation index (SII) on early postoperatively developing MACCE, in patients who underwent isolated CABG operation

Methods: The patients between the ages of 20 and 85 years who underwent consecutive isolated CABG operation in our clinic between May 15th, 2016, and May 15th, 2020, were included in the study retrospectively. In the postoperative period (within a month), those who did not develop MACCE were recorded as Group 1, and those who developed MACCE as Group 2.

Results: A total of 297 consecutive patients were included in the study. Group 1 had 263 patients with a median age of 63 (32-80), Group 2 had 34 patients with a median age of 70 (36-85) (P=0.008). There was no difference between the groups in terms of gender, history of cerebrovascular events, smoking, body mass index, hyperlipidemia, ejection fraction, and chronic obstructive pulmonary disease rates. As a result of multivariate analysis, advanced age (OR: 1.230 CI 95%: 1.050-1.319 P=0.024), NLR (OR: 1.974 CI 95%: 1.614-3.120, P=0.009), SII (OR: 3.880, CI 95%: 2.690-6.150, P<0.001) and PNI (OR: 2.424, CI 95%: 1.880-3.880, P=0.002) values were determined as independent predictors for predicting early postoperative MACCE.

Conclusion: With this study we revealed that SII and PNI values, which are among the inflammatory parameters and which can be obtained cheaply and easily, may be good predictors for MACCE emerging after CABG operations.

Keywords

Coronary artery bypass grafting, Inflammation, Nutritional index, Postoperative complication

Koroner Arter Bypass Operasyonları Sonrasında Ortaya Çıkan Major Advers Kardiyovasküler Ve Serebral Olayları Öngörmede Sistemik Immun Inflamatuar Indeks Ve Prognostik Nutrisyonel Indeksin Yerlerinin Araştırılması

Abstract

Amaç: Koroner arter hastalığı için en değerli tedavi yöntemi koroner arter baypas greft (KABG) ameliyatıdır. Başlıca kardiyovasküler ve serebral olaylar (MACCE) önemli sorunlardır ve bu konuda olası risk faktörlerini ortaya çıkarmak çok önemlidir. Bu çalışmada, izole KABG operasyonu geçiren hastalarda erken postoperatif gelişen MACCE üzerine prognostik nutrisyonel indeks (PNI) ve sistemik immün inflamasyon indeks (SII)’in prediktif yerlerini araştırmayı amaçladık.

Yöntemler: Kliniğimizde 15.05.2016-15.05.2020 tarihleri arasında ardışık izole KABG operasyonu geçiren 20-85 yaşları arasındaki hastalar retrospektif olarak çalışmaya dahil edildi. Postoperatif dönemde (bir ay içinde) MACCE gelişmeyenler Grup 1, MACCE gelişenler Grup 2 olarak kaydedildi.

Bulgular: Çalışmaya toplam 297 ardışık hasta dahil edildi. Grup 1'de medyan yaşı 63 (32-80) olan 263 hasta, Grup 2'de medyan yaşı 70 (36-85) olan 34 hasta vardı (P = 0.008). Gruplar arasında cinsiyet, serebrovasküler olay öyküsü, sigara kullanımı, vücut kitle indeksi, hiperlipidemi, ejeksiyon fraksiyonu ve kronik obstrüktif akciğer hastalığı oranları açısından fark yoktu. Çok değişkenli analizin sonucunda ileri yaş (OR: 1.230 CI 95%: 1.050-1.319 P=0.024), NLR (OR: 1.974 CI 95%: 1.614-3.120, P=0.009), SII (OR: 3.880, CI 95%: 2.690-6.150, P<0.001) and PNI (OR: 2.424, CI 95%: 1.880-3.880, P=0.002) değerleri erken postoperatif MACCE'yi öngörmede bağımsız prediktörler olarak tespit edildi.

Sonuç: Bu çalışma ile, ucuz ve kolay elde edilebilen inflamatuar parametreler arasında yer alan SII ve PNI değerlerinin, KABG operasyonlarından sonra ortaya çıkan MACCE için iyi prediktörler olabileceğini ortaya koyduk.

Keywords

Koroner arter baypas greft, İnflamasyon, Nutrisyonel indeks, Postoperatif komplikasyon

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