Yıl: 2023 Cilt: 28 Sayı: 1 Sayfa Aralığı: 123 - 128 Metin Dili: İngilizce DOI: 10.5505/ejm.2023.12989 İndeks Tarihi: 06-06-2023

Which Is More Effective In Determining The Risk of Mortality and Complications After Coronary Artery Bypass Graft Surgery; Body Mass Index Or Albumin?

Öz:
Preoperative risk analysis is important in predicting post operative outcomes in patients undergoing cardiac surgery.These analyzed risk factors influence both the mortality and the morbidity results of coronary artery bypass graft (CABG) surgery. The aim of this study is to emphasize that the serum albumin value is a predictor of survival during the preoperative period for the patients that we prepared for surgery, and to indicate whether body mass index (BMI) is as valuable as albumin in predicting survival and postoperative period results. This study included patients who underwent CABG surgery between 2019 -2020 at the Cardiac Surgery Center. Patient’s demographic information and all laboratory data were collected. Patients were grouped according to BMI and serum albumin values. Descriptive statistics for the continuous variables were presented as Mean, Standard deviation while count and percentages for categorical variables. A total of 174 patients, who underwent CABG surgery were included in the study.While postoperative complications were seen in 3.2% of patients with high BMI (>30 kg/m2), these complications did not develop in patients with low BMI (<20 kg/m2) (P=0.034).Patients who have serum albumin levels below 2.5g/dL are 22 times more likely to exitus than patients who have normal albumin levels (p=0.001, OR=22.246) whereas patients with normal BMI, obese patients have 16 times higher risk of exitus after bypass (OR=15.952) When we compare albumin and BMI, more extensive studies are needed to determine whether low serum albumin or increased BMI can independently predict the risk factors for poor short-term surgical outcomes.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Schwann TA, Habib RH, Wallace A et all. Operative outcomes of multiple-arterial versus single-arterial coronary bypass grafting. The Annals of thoracic surgery 2018; 105(4):1109-19.
  • 2. Watanabe A, Kohnoe S, Shimabukuro R et al. Risk factors associated with surgical site infection in upper and lower gastrointestinal surgery Surgery today. 2008; 38(5):404-12.
  • 3. Hussain SM, Zia K, Mangi AR et al. Operative Mortality of Coronary Artery Bypass Grafting in Patients with Low Serum Albumin after Nutritional Support. Pakistan Heart Journal 2021; 54(3):235-8.
  • 4. Bowdish ME, D’Agostino RS, Thourani VH et al. The Society of Thoracic Surgeons adult cardiac surgery database: 2020 update on outcomes and research. The Annals of thoracic surgery 2020; 109(6):1646-55.
  • 5. Engelman DT, Ali WB, Williams JB et al. Guidelines for perioperative care in cardiac surgery: enhanced recovery after surgery society recommendations. JAMA surgery 2019; 154(8):755-66.
  • 6. Kingeter AJ, Raghunathan K, Munson SH et al. Association between albumin administration and survival in cardiac surgery: a retrospective cohort study. Canadian Journal of Anesthesia/Journal canadien d'anesthésie. 2018; 65(11):1218-27.
  • 7. Doweiko JP, Nompleggi DJ. The role of albumin in human physiology and pathophysiology, Part III: Albumin and disease states. JPEN. Journal of parenteral and enteral nutrition 1991; 15(4):476- 83.
  • 8. Kim S, McClave SA, Martindale RG, Miller KR, Hurt RT. Hypoalbuminemia and clinical outcomes: what is the mechanism behind the relationship?. The American Surgeon 2017; 83(11):1220-7.
  • 9. Zitser-Gurevich Y, Simchen E, Galai N, Mandel M, ISCAB Consortium. Effect of perioperative complications on excess mortality among women after coronary artery bypass: the Israeli Coronary Artery Bypass Graft Study (ISCAB). The Journal of Thoracic and Cardiovascular Surgery. 2002; 123(3):517-24.
  • 10. Van Straten AH, Bramer S, Hamad MA et al. Effect of body mass index on early and late mortality after coronary artery bypass grafting.The Annals of thoracic surgery 2010; 89(1):30-7.
  • 11. Habib P, Scrocco JD, Terek M, Vanek V, Mikolich JR. Effects of bariatric surgery on inflammatory, functional and structural markers of coronary atherosclerosis. The American journal of cardiology 2009; 104(9):1251-5.
  • 12. Stamou SC, Nussbaum M, Stiegel RM et al. Effect of body mass index on outcomes after cardiac surgery: is there an obesity paradox?. The Annals of Thoracic Surgery 2011; 91(1):42-7.
  • 13. Delgado-Rodríguez M, Medina-Cuadros M, Gómez-Ortega A et al. Cholesterol and serum albumin levels as predictors of cross infection, death, and length of hospital stay. Archives of surgery. 2002; 137(7):805-12.
  • 14. Lohsiriwat V, Lohsiriwat D, Boonnuch W, Chinswangwatanakul V, Akaraviputh T, Lert- Akayamanee N. Pre-operative hypoalbuminemia is a major risk factor for postoperative complications following rectal cancer surgery.World journal of gastroenterology 2008 ;14(8):1248.
  • 15. DiMaria Ghalili, Rose Ann. Nutrition risk factors in older coronary artery bypass graft patients.Nutrition in Clinical Practice 2008; 23(5):494-500.
  • 16. Goh S. L., De Silva R. P., Dhital K., Gett R. M. Is low serum albumin associated with postoperative complications in patients undergoing cardiac surgery?. Interactive cardiovascular and thoracic surgery 2015; 21(6) :777-86.
  • 17. Rapp-Kesek D, Ståhle E, Karlsson T. Body mass index and albumin in the preoperative evaluation of cardiac surgery patients. Clinical nutrition 2004; 23(6):1398-404.
  • 18. Zhao D, Chen S, Liu Y et al. Blood Urea Nitrogen-to-Albumin Ratio in Predicting Long- Term Mortality in Patients Following Coronary Artery Bypass Grafting: An Analysis of the MIMIC-III Database. Frontiers in surgery. 2022; 9.
  • 19. Dudina A, Cooney MT, Bacquer DD et al. Relationships between body mass index, cardiovascular mortality, and risk factors: a report from the SCORE investigators. European Journal of Cardiovascular Prevention & Rehabilitation. 2011;18(5):731-42.
  • 20. Bhamidipati CM, LaPar DJ, Mehta GS et al. Albumin is a better predictor of outcomes than body mass index following coronary artery bypass grafting. Surgery. 2011; 150(4):626-34.
  • 21. Zimmerman JE, Kramer AA, McNair DS, Malila FM. Acute Physiology and Chronic Health Evaluation (APACHE) IV: hospital mortality assessment for today’s critically ill patients. Critical care medicine 2006; 34(5):1297-310.
APA Atabey R, Şahinalp Ş (2023). Which Is More Effective In Determining The Risk of Mortality and Complications After Coronary Artery Bypass Graft Surgery; Body Mass Index Or Albumin?. , 123 - 128. 10.5505/ejm.2023.12989
Chicago Atabey Rukiye Derin,Şahinalp Şahin Which Is More Effective In Determining The Risk of Mortality and Complications After Coronary Artery Bypass Graft Surgery; Body Mass Index Or Albumin?. (2023): 123 - 128. 10.5505/ejm.2023.12989
MLA Atabey Rukiye Derin,Şahinalp Şahin Which Is More Effective In Determining The Risk of Mortality and Complications After Coronary Artery Bypass Graft Surgery; Body Mass Index Or Albumin?. , 2023, ss.123 - 128. 10.5505/ejm.2023.12989
AMA Atabey R,Şahinalp Ş Which Is More Effective In Determining The Risk of Mortality and Complications After Coronary Artery Bypass Graft Surgery; Body Mass Index Or Albumin?. . 2023; 123 - 128. 10.5505/ejm.2023.12989
Vancouver Atabey R,Şahinalp Ş Which Is More Effective In Determining The Risk of Mortality and Complications After Coronary Artery Bypass Graft Surgery; Body Mass Index Or Albumin?. . 2023; 123 - 128. 10.5505/ejm.2023.12989
IEEE Atabey R,Şahinalp Ş "Which Is More Effective In Determining The Risk of Mortality and Complications After Coronary Artery Bypass Graft Surgery; Body Mass Index Or Albumin?." , ss.123 - 128, 2023. 10.5505/ejm.2023.12989
ISNAD Atabey, Rukiye Derin - Şahinalp, Şahin. "Which Is More Effective In Determining The Risk of Mortality and Complications After Coronary Artery Bypass Graft Surgery; Body Mass Index Or Albumin?". (2023), 123-128. https://doi.org/10.5505/ejm.2023.12989
APA Atabey R, Şahinalp Ş (2023). Which Is More Effective In Determining The Risk of Mortality and Complications After Coronary Artery Bypass Graft Surgery; Body Mass Index Or Albumin?. Eastern Journal of Medicine, 28(1), 123 - 128. 10.5505/ejm.2023.12989
Chicago Atabey Rukiye Derin,Şahinalp Şahin Which Is More Effective In Determining The Risk of Mortality and Complications After Coronary Artery Bypass Graft Surgery; Body Mass Index Or Albumin?. Eastern Journal of Medicine 28, no.1 (2023): 123 - 128. 10.5505/ejm.2023.12989
MLA Atabey Rukiye Derin,Şahinalp Şahin Which Is More Effective In Determining The Risk of Mortality and Complications After Coronary Artery Bypass Graft Surgery; Body Mass Index Or Albumin?. Eastern Journal of Medicine, vol.28, no.1, 2023, ss.123 - 128. 10.5505/ejm.2023.12989
AMA Atabey R,Şahinalp Ş Which Is More Effective In Determining The Risk of Mortality and Complications After Coronary Artery Bypass Graft Surgery; Body Mass Index Or Albumin?. Eastern Journal of Medicine. 2023; 28(1): 123 - 128. 10.5505/ejm.2023.12989
Vancouver Atabey R,Şahinalp Ş Which Is More Effective In Determining The Risk of Mortality and Complications After Coronary Artery Bypass Graft Surgery; Body Mass Index Or Albumin?. Eastern Journal of Medicine. 2023; 28(1): 123 - 128. 10.5505/ejm.2023.12989
IEEE Atabey R,Şahinalp Ş "Which Is More Effective In Determining The Risk of Mortality and Complications After Coronary Artery Bypass Graft Surgery; Body Mass Index Or Albumin?." Eastern Journal of Medicine, 28, ss.123 - 128, 2023. 10.5505/ejm.2023.12989
ISNAD Atabey, Rukiye Derin - Şahinalp, Şahin. "Which Is More Effective In Determining The Risk of Mortality and Complications After Coronary Artery Bypass Graft Surgery; Body Mass Index Or Albumin?". Eastern Journal of Medicine 28/1 (2023), 123-128. https://doi.org/10.5505/ejm.2023.12989