Koroner Arter Baypas Cerrahisi Sonrası Gelişen Hastane İçi Mortalite ve Komplikasyonlar, Preoperatif Değerlerle Prediksiyon Mümkün mü?
Amaç: Bu çalışmanın amacı, izole koroner arter baypas cerrahisi geçiren hastalardaki, kısa dönemde gelişen komplikasyon ve mortalitenin, literatürde sık kullanılan preoperatif prediktörler ile değerlendirilmesidir. Yöntem: Kardiyopulmoner baypas pompası kullanılarak koroner arter baypas cerrahisi yapılan 518 hasta retrospektif olarak araştırılmıştır. Preoperatif açlık kan glukozu, hemoglobin, nötrofil, platelet sayısı, eritrosit dağılım genişliği, ortalama platelet hacmi, platelet lenfosit oranı, nötrofil lenfosit oranı, metabolik sendrom kriterleri kaydedilmiştir. Bu preoperatif verilerin postoperatif kısa dönem komplikasyonlar ve mortalite ile ilişkisi araştırılmıştır. Bulgular: 518 hastanın 26’sında (%5) 30-günlük mortalite gözlenmiştir. Mortalite ile ileri yaş, hipertansiyon varlığı, açlık kan glukozu ve platelet lenfosit oranı ilişkili bulunmuştur. Ancak, çok değişkenli analizlerde yalnızca ileri yaşın mortalite için bağımsız prediktör olduğu görülmüştür. Hastaların 66’sında (%12,7) postoperatif en az bir komplikasyon görülmüştür. Yaş, açlık kan glukozu, hemoglobin değeri, ortalama platelet hacmi, nötrofil lenfosit oranı komplikasyon gelişimi ile lişkili bulunmuştur. Ancak çok değişkenli analizlerde yalnızca ileri yaş komplikasyon gelişimi için bağımsız prediktör olarak görülmüştür. Sonuç: Yalnızca preoperatif veriler ile koroner arter baypas cerrahisi geçiren hastalarda mortalite ve komplikasyon öngörmek olası değildir.
In-Hospital Mortality and Complications Following Coronary Artery Bypass Surgery; is it Possible to Predict with Preoperative Values?
Objective: The aim of this study is to evaluate short-term complications and mortality in patientsundergoing isolated coronary artery bypass surgery with preoperative predictors commonly usedin the literature.Methods: A total of 518 patients who underwent coronary artery bypass surgery using cardiopulmonary bypass pump were retrospectively investigated. Preoperative fasting blood glucose,hemoglobin, neutrophil, platelet count, erythrocyte distribution width, mean platelet volume,platelet lymphocyte ratio, neutrophil lymphocyte ratio, metabolic syndrome criteria were recorded. These preoperative data have been investigated in relation to postoperative short termcomplications and mortality.Results: Twenty-six (5%) out of 518 patients exited within postoperative 30 days. Mortality wasassociated with advanced age, presence of hypertension, fasting blood glucose and plateletlymphocyte ratio. However, in multivariate analyzes, only advanced age was seen as an independent predictor of mortality. At least one postoperative complication was seen in 66 (12.7%)patients. Age, fasting blood glucose, hemoglobin value, mean platelet volume, neutrophillymphocyte ratio were found to be associated with the development of complications. However,in multivariate analyzes only age was seen as independent predictor of development of complications.Conclusion: It is not possible to predict mortality and complications in patients undergoing coronary artery bypass surgery using only preoperative data.
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