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

Yıl 2024, , 183 - 190, 14.06.2024

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

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

Öz

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.

Anahtar Kelimeler

Open Heart Surgey, NPS Score, surgical reexploration

Kaynakça

• 1.Mehran R, Rao SV, Bhatt DL, et al. Standardizedbleeding definitions for cardiovascular clinical trials. Circulation. 2011;123:2736-47.
• 2.Van Venrooji LM, van Leeuwen PA, de Vos R,Borgmeijer-Hoelen MM, de Mol BA. 2008.Postoperative protein and energy intake andpostop¬erative complications in well-nourished,non-hospitalized elderly cardiac surgery patients.ClinNutr 27: 117-21.
• 3.TekerAçıkel ME, Korkut AK. Impact of ControllingNutritional Status Score (CONUT) and PrognosticNutritional Index (PIN) on Patients UndergoingCoronary Artery Bypass Graft Surgery. Heart SurgForum. 2019 Jul 25;22(4):E294-E297. doi:10.1532/hsf.2493. PMID: 31398095.
• 4.Gürbak İ, Güner A, Güler A, et al. Prognosticinfluence of objective nutritional indexes onmortality after surgical aortic valve replacement inelderly patients with severe aortic stenosis (fromthe nutrition-SAVR trial). J Card Surg. 2021Jun;36(6):1872-81. doi: 10.1111/jocs.15434. Epub2021 Feb 14. PMID: 33586213.
• 5.Karaçalılar M, Özbek M. Predictive effect ofnutritional scores assessment for 1-year mortality in patients with severe aortic stenosis treated withSAVR or TAVR. Eur Rev Med Pharmacol Sci. 2023Mar;27(5):1904-1911. doi:10.26355/eurrev_202303_31556. PMID: 36930487.
• 6.Li J, Yang W, Yuan Y, et al. Preoperative Naplesprognostic score is a reliable prognostic indicatorfor newly diagnosed glioblastoma patients. FrontOncol. 2022 Aug 16;12:775430. doi:10.3389/fonc.2022.775430. PMID: 36052263;PMCID: PMC9424989.
• 7.Xu R, Hao M, Zhou W, et al. Preoperativehypoalbuminemia in patients undergoing cardiacsurgery: a meta-analysis. Surg Today. 2023Aug;53(8):861-872. doi: 10.1007/s00595-022-02566-9. Epub 2022 Aug 7. PMID: 35933630.
• 8.Arbel Y, Finkelstein A, Halkin A, et.al. 2012.Neutrophil/lymphocyte ratio is related to theseverity of coronary artery disease and clinicaloutcome in patients undergoing angiography.Atherosclerosis 225 (2); 456-60.
• 9.Özbek M., ACUN B., ARIK B., et al. (2022).Prognostic value of nutritional and inflammatoryscores in Transcatheter aortic valve replacementpatients. Dicle Tıp Dergisi, 49(3), 422-9.
• 10.Li S, Wang H, Yang Z, et al. Naples PrognosticScore as a novel prognostic prediction tool in video-assisted thoracoscopic surgery for early-stage lungcancer: a propensity score matching study.SurgEndosc. 2021 Jul;35(7):3679-3697. doi:10.1007/s00464-020-07851-7. Epub 2020 Aug 3.PMID: 32748268.
• 11.Cho L, Kibbe MR, Bakaeen F, et al. CardiacSurgery in Women in the Current Era: What Are theGaps in Care? Circulation. 2021 Oct 5;144(14):1172-1185. doi: 10.1161/CIRCULATIONAHA.121.056025. Epub 2021 Oct 4. PMID: 34606298.
• 12.Ehrsam JP, Aigner C. Chirurgie des altenMenschen – Thoraxchirurgie [Surgery of old people-Thoracic surgery]. Wien Klin Mag. 2023;26(3):112-121.German. doi: 10.1007/s00740-023-00497-w.Epub 2023 Apr 25. PMID: 37251530; PMCID:PMC10126566.
• 13.Wheatley J, Liu Z, Loth J, et al. The prognosticvalue of elevated neutrophil-lymphocyte ratio forcardiac surgery-associated acute kidney injury: Asystematic review and meta-analysis. ActaAnaesthesiol Scand. 2023 Feb;67(2):131-141. doi: 10.1111/aas.14170. Epub 2022 Nov 25. PMID: 36367845; PMCID: PMC10099461.
• 14.Li R, Luo Q, Yanavitski M, Huddleston SJ.Smoker's paradox in transcatheter aortic valvereplacement: A National Inpatient Sample analysisfrom 2015 to 2020. CardiovascRevasc Med. 2023Nov 30:S1553-8389(23)00921-1. doi:10.1016/j.carrev.2023.11.021. Epub ahead of print.PMID: 38052714.