EVALUATION OF LABORATORY AND IMAGING PARAMETERS IN PATIENTS UNDERGOING OPEN HEART SURGERY

Yıl 2026, Cilt: 28 Sayı: 1 , 16 - 24 , 27.04.2026

Furkan Çağrı Oğuzlar , Ali Halıcı , Ezgi Cesur , Hamit Hakan Armağan , Kadir Burhan Karadem

https://doi.org/10.24938/kutfd.1756921

https://izlik.org/JA55GG75RS

Öz

Objective: Coronary artery bypass grafting (CABG) remains a widely performed surgical intervention for coronary artery disease. Despite advances in perioperative care and preoperative risk stratification, postoperative complications and mortality continue to pose significant clinical challenges. This study aimed to investigate the prognostic value of platelet related parameters specifically, mean platelet volume (MPV) and platelet count (PLT) in predicting postoperative outcomes and 30-day mortality in patients undergoing CABG.
Material and Methods: This retrospective, single-center study included 406 adult patients who presented to the emergency department with acute coronary syndrome and subsequently underwent isolated CABG between 2019 and 2023. Demographic characteristics, preoperative EuroSCORE II and logEuroSCORE values, laboratory parameters and echocardiographic findings were recorded. Postoperative outcomes included 30-day mortality, major adverse cardiac events (MACE) and composite poor outcomes. Hematologic and biochemical parameters were analyzed at admission and on postoperative day 30 or the day of death. Associations between these variables and clinical outcomes were assessed using ROC and regression analyses.
Results: Among the 406 patients (mean age: 63.5±8.6 years; 76.1% male), the 30-day mortality rate was 4.7%, with MACE and poor outcomes occurring in 9.4% and 10.1% of cases, respectively. Postoperative MPV and PLT were significantly associated with all outcome groups (p <0.05). MPV demonstrated the highest predictive accuracy for mortality (AUC: 0.791 95% CI: 0.748-0.830), whereas PLT exhibited the strongest performance for predicting MACE (AUC: 0.691 95% CI: 0.644-0.736). Multivariate analysis confirmed that postoperative MPV was an independent predictor of mortality (OR: 2.738; 95% CI: 1.842-4.072; p <0.001).
Conclusion: Routine postoperative monitoring of MPV and PLT may enhance early detection of high-risk patients following CABG, particularly among those initially classified as low-risk.These simple, ccessible markers could support clinical decision-making and improve outcomes in the early postoperative period.

Anahtar Kelimeler

Coronary artery bypass grafting , mean platelet volume , platelet count , prognosis

Açık Kalp Cerrahisi Geçiren Hastalarda Laboratuvar ve Görüntüleme Parametrelerinin Değerlendirilmesi

https://izlik.org/JA55GG75RS

Öz

Amaç: Koroner arter bypass greftleme (KABG), koroner arter hastalığının tedavisinde yaygın olarak uygulanan bir cerrahi girişimdir. Perioperatif bakım ve preoperatif risk sınıflamasındaki ilerlemelere rağmen, postoperatif komplikasyonlar ve mortalite önemli klinik sorunlar olmaya devam etmektedir. Bu çalışmada, trombosit ile ilişkili parametrelerden ortalama trombosit hacmi (MPV) ve trombosit sayısının (PLT), KABG uygulanan hastalarda postoperatif sonuçlar ve 30 günlük mortaliteyi öngörmedeki prognostik değerleri araştırıldı.
Gereç ve Yöntemler: Bu retrospektif, tek merkezli çalışmaya 2019-2023 yılları arasında akut koroner sendrom ile acil servise başvuran ve izole KABG uygulanan 406 erişkin hasta dâhil edildi. Hastaların demografik özellikleri, preoperatif EuroSCORE II ve logEuroSCORE değerleri, laboratuvar parametreleri ve ekokardiyografik bulguları kaydedildi. Postoperatif sonuçlar; 30 günlük mortalite, majör kardiyak olaylar (MACE) ve kötü klinik sonuçlar olarak tanımlandı. Hematolojik ve biyokimyasal parametreler başvuru anında ve postoperatif 30. günde veya ölüm gününde analiz edildi. Bu değişkenler ile klinik sonuçlar arasındaki ilişkiler ROC ve regresyon analizleri ile değerlendirildi.
Bulgular: Çalışmaya dâhil edilen 406 hastanın (ortalama yaş: 63.5±8.6 yıl; %76.1 erkek) 30 günlük mortalite oranı %4.7, MACE oranı %9.4 ve kötü sonuç oranı %10.1 olarak saptandı. Postoperatif MPV ve PLT tüm sonuçlarla anlamlı ilişkili bulundu (p <0.05). MPV, mortalite için en yüksek öngörü doğruluğunu gösterdi (AUC: 0.791; %95 GA: 0.748-0.830), PLT ise MACE’i öngörmede en güçlü parametreydi (AUC: 0.691; %95 GA: 0.644-0.736). Çok değişkenli analizde postoperatif MPV, mortalitenin bağımsız bir prediktörü olarak saptandı (OR: 2.738; %95 GA: 1.842-4.072; p <0.001).
Sonuç: Postoperatif dönemde MPV ve PLT’nin rutin takibi, özellikle başlangıçta düşük riskli olarak sınıflandırılan hastalarda yüksek riskli grupların erken dönemde belirlenmesine katkı sağlayabilir. Bu basit ve erişilebilir biyobelirteçler, klinik karar sürecini destekleyerek postoperatif hasta sonuçlarını iyileştirebilir.

Anahtar Kelimeler

Koroner arter baypas greftleme , ortalama trombosit hacmi , trombosit sayısı , prognoz

Kaynakça

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