Year 2021, Volume 7 , Issue 4, Pages 432 - 439 2021-07-04

Importance of prognostic nutritional index in on-pump coronary artery bypass graft surgery

Arif GUCU [1]


Objectives: A simple and appropriate risk index is still required to show the patient's nutritional status undergoing coronary artery bypass graft (CABG) surgery. This study aimed to evaluate the Prognostic Nutritional Index (PNI) value as a predictor of in-hospital mortality in patients undergoing CABG surgery.

Methods: In this study, we scanned the medical data of 742 patients’ who underwent on-pump CABG surgery retrospectively. Patients' were divided into two groups based on the PNI cut-off value (high-risk group, PNI < 45.85, n = 230; low-risk group, PNI ≥ 45.85, n = 512).

Results: To analyze the factors affecting in-hospital mortality in the postoperative period, univariate and multivariate logistic regression analysis was performed. In univariate analysis, advanced age (Odds ratio (OR): 1.219, 95% confidence interval (CI): 1.194-2.669, p < 0.001), left ventricular ejection fraction (LVEF) (OR: 3.471, 95% CI: 2.854-6.927, p < 0.001), total perfusion time (OR: 0.876, 95% CI: 0.690-0.954, p = 0.012), intra-aortic balloon pump (IABP) use (OR: 2.148, 95% CI: 1.394-2.889, p = 0.002), preoperative high creatinine (OR: 1.229, 95% CI: 1.066-2.118, p = 0.019), low lymphocyte count (OR: 0.879, 95% CI: 0.789-0.945, p = 0.017), low albumin (OR: 1.682, 95% CI: 1.433-2.765, p = 0.003), high C-reactive protein (CRP) (OR: 1.0.790, 95% CI: 0.678-0.927, p = 0.042) and low PNI (OR: 1.290, 95% CI: 1.119-1.654, p < 0.001) were correlated with the postoperative mortality. In multivariate logistic regression analysis, advanced age (OR: 1.145, 95% CI: 1.110-1.938, p = 0.017), LVEF (OR: 2.916, 95% CI: 1.768-4.928, p < 0.001), IABP use (OR: 1.880, 95% CI: 1.350-2.554, p = 0.032) and PNI (OR: 0.932, 95% CI: 0.889-0.978, p = 0.004) were independent predictors of mortality.

Conclusions: In on-pump CABG surgery, postoperative mortality is associated with low preoperative PNI, and can be a useful and suitable parameter for preoperative risk evaluation.

Prognostic nutritional index, Nutritional status, CABG surgery, Cardiopulmonary bypass, Risk factors
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Primary Language en
Subjects Cardiac and Cardiovascular Systems
Journal Section Original Articles
Authors

Orcid: 0000-0002-7464-3362
Author: Arif GUCU (Primary Author)
Institution: Department of Cardiovascular Surgery, University of Health Sciences, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
Country: Turkey


Thanks I would like to thank the Bursa Yuksek Ihtisas Research and Training Hospital cardiovascular surgery team for all these operations.
Dates

Application Date : June 3, 2021
Acceptance Date : June 27, 2021
Publication Date : July 4, 2021

EndNote %0 The European Research Journal Importance of prognostic nutritional index in on-pump coronary artery bypass graft surgery %A Arif Gucu %T Importance of prognostic nutritional index in on-pump coronary artery bypass graft surgery %D 2021 %J The European Research Journal %P -2149-3189 %V 7 %N 4 %R doi: 10.18621/eurj.947388 %U 10.18621/eurj.947388