Koroner Arter Baypas Greftleme Operasyonu Yapılan Hastalarda Postoperatif Komplikasyonların D Vitamini Seviyeleriyle İlişkisinin Retrospektif Değerlendirilmesi

Year 2022, Volume: 1 Issue: 3, 73 - 79, 30.12.2022

Izatullah Jalalzai , Hakan Usta , Ebubekir Sönmez , İbrahim Pir , Yasin Kılıç , Ümit Arslan , Merve Çetin , Bilgehan Erkut

Abstract

Giriş: Vasküler yapılar üzerindeki negatif etkileri nedeniyle düşük Vitamin D (VD) düzeyleri koroner arter hastalığı (KAH) için önemli bir risk faktörü kabul görmesine rağmen, VD eksikliğinin koroner arter baypas greftleme (KABG) operasyonlarının postoperatif komplikasyonları ile ilişkisi net değildir. Çalışmada KABG uygulanan hastalarda gelişen postoperatif komplikasyonlar ve VD seviyeleri arasındaki ilişkinin araştırılmasını amaçladık.
Metod: KABG operasyonu planlanan ve preoperatif dönemde VD seviyeleri ölçülmüş olan 150 hasta çalışmaya alındı. Veriler retrospektif incelenerek, VD seviyelerine göre 150 hasta kontrol grubu (Grup A; 25-80 ng/mL) ve VD eksikliği grubu (Grup B; <25ng/mL) olarak ikiye ayrıldı. Preoperatif, intraoperatif ve postoperatif veriler kaydedildi. İlk 30 gün içindeki ölümler mortalite, hospitalizasyon boyunca gelişen morbidite de komplikasyon olarak değerlendirildi.
Bulgular: VD düzeyi 25-80 ng/mL olan Grup A’da 75 hastanın (Erkek/Kadın;53/22) yaş ortalaması 60.2±9.2 ve VD değerleri <25 ng/mL olan Grup B’de 75 hastanın (Erkek/Kadın; 48/27) yaş ortalaması 62.08±8.9 idi. Cinsiyet (p=0,243), yaş (p=0,232), vücut kitle indeksi (VKI; p=0,137), EuroScore (p=0,512) açısından gruplar arasında fark yoktu. Ortalama VD seviyeleri Grup A’da 42.6±13.8 ng/mL ve Grup B’de 10.08±5.7 ng/mL ölçüldü. (p<0,01) Kardiyopulmoner baypas (KPB; p=0,874) ve aortik kros klemp (AKK; p=0,495) süreleri Grup B’de daha uzundu. Yapılan anastomoz sayısı Grup A’da 3,27±0.79 ortalama ile Grup B’den (2.80±0.88) daha fazlaydı (p=0,01) ancak Grup B’de daha çok hastada pozitif inotropik destek gereksinimi olduğu görüldü. (p=0,03) Kümülatif mortalite oranımız %3,3 (Grup A/B:2/3) tespit edildi.
Sonuç: VD’nin kardiyovasküler sistem üzerindeki etkileri göz önüne alındığında, VD eksikliğinin vasküler yapılarda yaptığı patolojik değişikliklerin KABG operasyonlarını daha komplike hale getirebileceği akılda tutulmalıdır. VD eksikliğinin postoperatif dönemde net etkilerinin belirlenmesi için prospektif ve geniş çaplı çalışmalara ihtiyaç olduğu görüşündeyiz

Keywords

D vitamini, koroner arter hastalığı, koroner arter baypas greft, komplikasyon

Supporting Institution

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Project Number

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Thanks

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Retrospective Evaluation of Relationship between Postoperative Complications and Vitamin D Levels in Patients' performed Coronary Artery Bypass Grafting Operation

Abstract

Objectives: Although low levels of Vitamin D (VD) are considered an important risk factor in coronary artery disease (CAD) due to its negative effects on vascular structures, the relationship between VD deficiency and postoperative complications of coronary artery bypass grafting (CABG) operations is not clear. In present study, we aimed to investigate the relationship between postoperative complications and VD levels in patients who underwent CABG.
Methods: 150 patients who were decided to have CABG operation and whose VD levels were measured in the preoperative period were included in the study. The data were analyzed retrospectively, and 150 patients were divided into control group (Group A; 25-80 ng/mL) and VD deficiency group (Group B; <25ng/mL) according to their VD levels. Preoperative, intraoperative and postoperative data were recorded. Deaths within the first 30 days were accepted as mortality and morbidity during hospitalization were accepted as complications.
Results: Group A consisted of 75 patients (Male/Female; 53/22) with a VD level of 25-80 ng/mL and mean age was 60.2±9.2 years, and Group B consisted of 75 patients (Male/Female; 48/27) with a VD value of <25 ng/mL and mean age was 62.08±8.9 years. There was no difference between the groups in terms of gender (p=0.243), age (p=0.232), BMI (p=0.137), and EuroScore (p=0.512). Mean of VD levels were 42.6±13.8 ng/mL in Group A and 10.08±5.7 ng/mL in Group B. (p<0.01) Cardiopulmonary bypass (CPB; p=0.874) and aortic cross-clamp (ACC; p=0.495) times were longer in Group B. The number of anatomoses was higher in Group A than Group B (3.27±0.79 and 2.80±0.88, respectively) (p=0.01) but the need for positive inotropic support was higher in Group B patients. (p=0.03) The cumulative mortality rate was 3.3% (Group A/B:2/3).
Conclusion: Considering the effects of VD on the cardiovascular system, it should be kept in mind that VD deficiency may make complicate CABG operations due to pathological changes in vascular structures. We think that prospective large-scale studies are needed to determine the net effects of VD deficiency in the postoperative period.

Keywords

Vitamin D, coronary artery disease, coronary artery bypass graft, complication

Project Number

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