Bilirubin Adsorption Versus Plasma Exchange for Hyperbilirubinemia in Patients After Cardiac Surgery: A Retrospective Study

Abstract Objective: Hyperbilirubinemia after cardiac surgery increases in-hospital mortality and is associated with poor prognosis. Our present study aimed to compare the efficacy of bilirubin adsorption (BA) and plasma exchange (PEX) in patients with hyperbilirubinemia after cardiac surgery.Methods: We retrospectively included patients who underwent BA treatment or PEX treatment due to severe hyperbilirubinemia after cardiac surgery in our center from 2015 to 2020. We collected examinations of urine and liver function before and after treatment and compared the in-hospital mortality and morbidity between two treatment groups. Results: A total of 56 patients were enrolled in this study, 14 patients received BA treatment and 42 patients received PEX treatment. BA group provided a statistically significant reduction in the TBil (p=0.016) and DBil (p=0.036) compared to PEX group. The in-hospital mortality was 85.7% (48/56) in the whole group, BA group had lower mortality than PEX group (71.4% vs. 90.5%, p=0.078). BA group showed better circulatory support, including lower risks of IABP (21.4% vs. 52.4%, p=0.044), ECMO (21.4% vs. 50.0%, p=0.061), re-intubation (64.3% vs. 40.5%, p=0.122) and ventricular arrhythmias (64.3% vs. 45.2%, p=0.217). The in-hospital mortality was still lower in BA treatment group than PEX treatment group (71.4% vs. 100%, p=0.049) in matched cohort.Conclusions: BA treatment had higher removal ability of bilirubin in patients with hyperbilirubinemia and could reduce the mortality and risks of poor clinical outcomes compared to PEX treatment. BA treatment should be considered as an effective treatment method for patients with higher TBil level or Dbil level.

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Bilirubin adsorption versus plasma exchange for hyperbilirubinemia in patients after cardiac surgery: a retrospective study

Journal of Cardiothoracic Surgery ◽

10.1186/s13019-021-01622-8 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Ke Pan ◽

He Zhang ◽

Kai Zhong ◽

Hai-tao Zhang ◽

Ze-shi Li ◽

...

Keyword(s):

Cardiac Surgery ◽

Treatment Group ◽

Hospital Mortality ◽

Plasma Exchange ◽

Total Bilirubin ◽

Liver Function Tests ◽

Direct Bilirubin ◽

Circulatory Support ◽

Mortality And Morbidity ◽

Bilirubin Adsorption

Abstract Objective Hyperbilirubinemia after cardiac surgery increases in-hospital mortality and is associated with poor prognosis. Our present study aimed to compare the efficacy of bilirubin adsorption (BA) and plasma exchange (PEX) in patients with hyperbilirubinemia after cardiac surgery. Methods We retrospectively included patients who underwent BA treatment or PEX treatment due to severe hyperbilirubinemia after cardiac surgery at our center from 2015 to 2020. We collected results from urine and liver function tests before and after treatment and compared the in-hospital mortality and morbidity between the two treatment groups. Results A total of 56 patients were enrolled in this study: 14 patients received BA treatment, and 42 patients received PEX treatment. Compared to the PEX group, the BA group exhibited a statistically significant reduction in total bilirubin (p = 0.016) and direct bilirubin (p = 0.036) levels. The in-hospital mortality was 85.7% (48/56) in the whole group, and the BA group had a lower mortality than the PEX group (71.4% vs. 90.5%, p = 0.078). The BA group showed better circulatory support, including lower risks of IABP (21.4% vs. 52.4%, p = 0.044), ECMO (21.4% vs. 50.0%, p = 0.061), reintubation (64.3% vs. 40.5%, p = 0.122) and ventricular arrhythmias (64.3% vs. 45.2%, p = 0.217). The in-hospital mortality was still lower in the BA treatment group than in the PEX treatment group (71.4% vs. 100%, p = 0.049) in the matched cohort. Conclusions Compared to PEX treatment, BA treatment had a higher bilirubin removal ability in patients with hyperbilirubinemia and could reduce the mortality and risks of poor clinical outcomes. BA treatment should be considered an effective treatment method for patients with higher total bilirubin or direct bilirubin levels.

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Complete blood cell count risk score as a predictor of in-hospital mortality and morbidity among patients undergoing cardiac surgery with cardiopulmonary bypass

International Journal of Cardiology ◽

10.1016/j.ijcard.2015.03.227 ◽

2015 ◽

Vol 187 ◽

pp. 60-62 ◽

Cited By ~ 1

Author(s):

Ana Paula Porto Rödel ◽

Manuela Borges Sangoi ◽

Larissa Garcia de Paiva ◽

Jossana Parcianello ◽

José Edson Paz da Silva ◽

...

Keyword(s):

Cardiac Surgery ◽

Cardiopulmonary Bypass ◽

Blood Cell ◽

Hospital Mortality ◽

Cell Count ◽

Risk Score ◽

Complete Blood Cell Count ◽

Blood Cell Count ◽

Mortality And Morbidity

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Introduction Of Universal Leucodepletion Associated With a Reduction In New Renal Failure, But Not Infection Or Mortality, In Cardiac Surgery Patients: Results From a Before and After Study

Blood ◽

10.1182/blood.v122.21.788.788 ◽

2013 ◽

Vol 122 (21) ◽

pp. 788-788 ◽

Cited By ~ 1

Author(s):

Zoe K. McQuilten ◽

Nick Andrianopoulos ◽

Leo Van De Watering ◽

Louise E. Phillips ◽

Merrole Faye Cole-Sinclair ◽

...

Keyword(s):

Renal Failure ◽

Cardiac Surgery ◽

Linear Regression ◽

Research Funding ◽

Outcome Data ◽

Mortality And Morbidity ◽

Significant Difference ◽

Before And After ◽

Surgical History ◽

Perfusion Time

Abstract Background and Aim Studies have reported association between red cell (RBC) transfusion (tx) and increased mortality and morbidity in cardiac surgery (CS). Conflicting data exist on whether universal RBC leucodepletion (ULD) reduces mortality and morbidity, particularly infection and intensive care unit (ICU) length of stay (LOS), in CS patients. RBC tx has also been independently associated with renal failure (RF) in CS, however mechanisms for this effect are unclear. An inflammatory basis has been postulated. No large studies have explored the potential benefit of ULD in reducing RF. We investigated whether introduction of ULD in Australia (July 2008) was associated with reduced in-hospital mortality, infection, new RF (NRF) and ICU LOS in a large cohort of CS patients. Methods All consecutive CS patients 18y and older at 6 hospitals between 2005 and 2010 were included. Clinical and outcome data were obtained from the Australian and New Zealand Society for Cardiac and Thoracic Surgeons Cardiac Surgery Database, which prospectively collects data on all CS patients. Laboratory results (pre-operative hemoglobin, platelet, coagulation profile and creatinine) and transfusion data were obtained from hospital laboratory information systems (LIS). Statistical analysis Tx was defined as ≥ 1 RBC within 48h of CS. Patients were categorized as having surgery pre- or post-ULD and as having received either exclusively LD, non-LD or mixed RBC. Logistic regression modeled the association between LD and mortality, infection and NRF. The association with LD was analyzed in two ways: whether surgery occurred pre- or post-ULD, and whether patients received LD or non-LD RBCs. To examine for trends over time, an equal number of non-tx patients were selected as ‘controls’, based on a propensity score for RBC tx. The relationship between LD and ICU LOS among survivors was explored using linear regression. Results 16,253 patients underwent CS in the study period. LIS data were available for 14,980 (92%), and of these, 8857 (59%) had surgery pre-ULD. RBC tx was given in 3799 (43%) pre-ULD, and 2525 (41%) post-ULD. Of the 6324 patients who were tx, 2794 (44%) received LD RBC, 2702 (43%) non-LD RBC and 828 (13%) received mixed LD and non-LD RBCs. In tx patients, there was no significant difference in mortality (136 [5.4%] vs. 240 [6.3%], p=0.125) or infection (310 [11.9%] vs. 510 [13.4%], p=0.080) post-ULD compared with pre-ULD, however there was a significant reduction in NRF (215 [8.5%] vs. 398 [10.5%], p=0.010). After adjusting for hospital, age, sex, co-morbidities, ejection fraction, pre-operative laboratory parameters, surgical history, type and urgency of procedure, pre-operative shock, medications, perfusion time, drain output in first 4 hours and number of RBC, there was no difference in mortality (OR 0.92, 95% CI 0.71-1.20, p=0.534) or infection (OR 0.96, 95% CI 0.81-1.15, p=0.671), however there was a difference in NRF post-ULD compared with pre-ULD (OR 0.77, 95% CI 0.64-0.94, p=0.011). When the analysis was repeated comparing those who received LD vs. non-LD RBC the results were similar, with no difference in mortality or infection, but a reduction in NRF (OR 0.80, 95% CI 0.65-0.98, p=0.035). In the non-tx controls, there was no significant difference in mortality (30 [1.2%] vs. 39 [1.0%], p=0.546), infection (139 [5.5%] vs. 231 [6.1%], p=0.338) or NRF (110 (4.4%] vs. 181 [4.8%], p=0.445) post-ULD compared with pre-ULD. After adjusting as above, there was no significant difference in mortality (OR 1.18, 95% CI 0.72-1.9, p=0.512), infection (OR 0.82, 95% CI 0.66-1.03, p=0.094) or NRF (OR 0.83, 95%CI 0.64-1.07, p=0.148) post-ULD compared with pre-ULD in non-tx pts. In the unadjusted linear regression, post-LD was associated with a small reduction in ICU LOS in transfused (41 vs. 44 h, p=0.034) and with a small increase in non-transfused (29 vs. 31 h, p<0.001). After adjustment there was no reduction in ICU LOS post-ULD. Conclusions Introduction of ULD was associated with a reduction in NRF but not mortality, infection or ICU LOS in transfused CS pts. These findings support the potential role of inflammation as a contributor to acute RF in tx CS pts. ULD may be worth exploring prospectively as a possible strategy to reduce the incidence of NRF in CS, given its substantial morbidity and mortality. Disclosures: Phillips: CSL Behring: Research Funding. Wood:CSL Behring: Research Funding.

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Gene Expression of PSORI-CM01 and Yinxieling in the Treatment of Psoriasis Vulgaris

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2021/6627286 ◽

2021 ◽

Vol 2021 ◽

pp. 1-13

Author(s):

Yue Lu ◽

Yao Qi ◽

Li Li ◽

Yuhong Yan ◽

Danni Yao ◽

...

Keyword(s):

Gene Expression ◽

Treatment Group ◽

Differentially Expressed Genes ◽

Psoriasis Vulgaris ◽

Drug Action ◽

Differentially Expressed ◽

Signalling Pathways ◽

Control Group ◽

Treatment Groups ◽

Before And After

Background. This study aimed to explore the mechanisms of action of the PSORI-CM01 and Yinxieling formulas in the treatment of patients with psoriasis vulgaris by analyzing gene expression in peripheral blood mononuclear cells (PBMCs). Methods. PBMC samples were collected from 21 patients before and after treatment. The study included nine patients in the PSORI-CM01 treatment group, 12 patients in the Yinxieling treatment group, and nine patients in the healthy control group. Gene expression levels in PBMCs were determined using the Affymetrix gene chip technology. Results. In the PSORI-CM01 group before and after treatment, a total of 668 differentially expressed genes were found, of which 445 were upregulated and 223 were downregulated. Before and after Yinxieling treatment, 657 differentially expressed genes were found, of which 168 were upregulated and 489 were downregulated. Venn analysis showed that 78 genes were not differentially expressed in the PSORI-CM01 group and 74 were not differentially expressed in the Yinxieling group compared with those in the controls. Among these genes, 72 genes were common to both groups, which were the genes on which the two drugs acted jointly. The results of KEGG analysis and Venn analysis on the signalling pathways of drug action in treatment groups showed that haemostasis and pathways involving Rho GTPases were common signalling pathways of drug action in the two groups. Conclusions. By a comparative analysis of the treatment groups, we found that both drugs have a positive effect on patients with psoriasis vulgaris, primarily by regulating the pathways related to platelet activation, aggregation, and blood coagulation. Trial registration: ChiCTR, ChiCTR-TRC-14005185, Registered 8 August 2014, http://www.chictr.org.cn/showproj.aspx?proj=4390

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Risk Factors for the Development of Nosocomial Pneumonia and Its Clinical Impact in Cardiac Surgery

10.21203/rs.3.rs-882631/v1 ◽

2021 ◽

Author(s):

Ferdinand Jr Rivera Gerod ◽

Edgar Ongjoco ◽

Rod Castro ◽

Armin Masbang ◽

Elmer Casley Repotente ◽

...

Keyword(s):

Risk Factors ◽

Mechanical Ventilation ◽

Cardiac Surgery ◽

Hospital Mortality ◽

Nosocomial Pneumonia ◽

Clinical Impact ◽

Adult Patients ◽

Mortality And Morbidity ◽

Factors Associated ◽

Prolonged Icu Stay

Abstract BackgroundThe development of nosocomial pneumonia after cardiac surgery is a significant post-operative complication that may lead to increased morbidity, mortality, and hospital cost. We aimed to identify risk factors associated with it and to determine its clinical impact in terms of in-hospital mortality and morbidity.MethodsThis is a retrospective cohort study conducted among all adult patients who underwent cardiac surgery from 2014-2019 in St. Luke’s Medical Center, Quezon City, Philippines. Baseline characteristics and possible risk factors for pneumonia were retrieved from medical records. Nosocomial pneumonia was based on the Centers for Disease Control and Prevention criteria. Clinical outcomes include in-hospital mortality and morbidity. Odds ratios from logistic regression was computed to determine risk factors associated with pneumonia using STATA 15.0.ResultsOut of 373 patients included in this study, 104 (28%) patients acquired pneumonia. Most surgeries were coronary artery bypass graft (CABG) (71.58%), followed by valve repair/replacement (29.76%). Neither age, sex, BMI, diabetes, LV dysfunction, renal dysfunction, COPD/asthma, urgency of surgery, surgical time, nor smoking showed association in the development of pneumonia. However, preoperative stay of >2 days was associated with 92.3% (95%CI 18–213%) increased odds of having pneumonia (p=.009). Also, every additional hour on mechanical ventilation conferred 0.8% (95%CI, 0.3–1%) greater odds of acquiring pneumonia (p=.003).Patients who developed pneumonia had 3.9 times odds of mortality (95%CI 1.51–9.89, p=.005), 3.8 times odds of prolonged hospitalization (95%CI 1.81–7.90,p<.001), 6.4 times odds of prolonged ICU stay (95%CI 3.59–11.35,p<.001), and 9.5 times odds of postoperative reintubation (95%CI 3.01–29.76,p<.001). ConclusionAmong adult patients undergoing cardiac surgeries, prolonged preoperative hospital stay and prolonged mechanical ventilation were both associated with an increased risk for nosocomial pneumonia. Those who developed pneumonia had worse outcomes with significantly increased in-hospital mortality, prolonged hospitalization, prolonged ICU stay, and increased postoperative re-intubation. Clinicians should therefore minimize delays in surgery to avoid unnecessary exposure to pathogenic organisms. Also, timely liberation from mechanical ventilation after surgery should be encouraged.

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Do Patients in Congestive Cardiac Failure Undergoing Cardiac Surgery Demonstrate Worse Outcomes Compared with Those with a History of Cardiac Failure?

The Heart Surgery Forum ◽

10.1532/hsf98.20101137 ◽

2011 ◽

Vol 14 (3) ◽

pp. 178

Author(s):

Saina Attaran ◽

Matthew Shaw ◽

Laura Bond ◽

Mark D. Pullan ◽

Brian M. Fabri

Keyword(s):

Cardiac Surgery ◽

Postoperative Complications ◽

Hospital Mortality ◽

Cardiac Failure ◽

Significant Risk ◽

Congestive Cardiac Failure ◽

Mortality And Morbidity ◽

Risk Of Mortality ◽

Creatine Kinase Mb ◽

History Of

Objectives: Cardiac surgery in patients with symptoms of congestive cardiac failure (CCF) carries a significant risk of mortality and morbidity. Except for emergencies and in unstable cases, the recommendation has been to delay the operation until the patient is fully recovered. The objective of this study was to determine the consequences of cardiac surgery in patients with acute decompensated heart failure and to compare their outcomes with the results of the operation in patients with previous CCF.Methods: We compared the outcomes of patients with CCF (n = 707) at the time of cardiac surgery (valve replacement or coronary artery bypass grafting [CABG]) with those with a history of CCF (n = 1583). The EuroSCORE was significantly higher in CCF patients (P < .001). Impaired renal function was also more commonly observed in patients with CCF (P < .001). After adjusting for preoperative characteristics, we compared the 2 groups with respect to postoperative complications, postoperative creatine kinase MB values, and in-hospital mortality.Results: Before adjusting for preoperative characteristics, we found that in-hospital mortality (15.5%) and postoperative complications, such as arrhythmias (31%), renal failure (19%), stroke (4.7%), and myocardial infarction (MI) (3%), were significantly higher in the CCF group than in those with a previous history of CCF. When the patients were matched for preoperative characteristics, the rates of postoperative MI and arrhythmia were the main complications that were significantly higher in the CCF group, compared with the patients with previous CCF. The 2 groups were not significantly different with respect to in-hospital mortality. The results were not affected by the type of procedure (valve or CABG), and the main factor influencing mortality was the EuroSCORE.Conclusion: Despite the significant risk of mortality and morbidity in patients with current CCF, cardiac surgery to reverse the cause should not be delayed in these patients, because doing so may lead to further deterioration. Other risk factors, however, should be taken into consideration on an individual basis.

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Effect of subzero-balanced ultrafiltration on postoperative outcome of patients after cardiopulmonary bypass

Perfusion ◽

10.1177/0267659109357977 ◽

2009 ◽

Vol 24 (6) ◽

pp. 401-408 ◽

Cited By ~ 3

Author(s):

Tao Zhang ◽

Chang-qing Gao ◽

Jia-chun Li ◽

Jia-li Wang ◽

Li-bing Li ◽

...

Keyword(s):

Cardiopulmonary Bypass ◽

Treatment Group ◽

Hospital Mortality ◽

Group Versus ◽

Postoperative Outcome ◽

Postoperative Recovery ◽

Postoperative Outcomes ◽

Control Group ◽

Mortality And Morbidity ◽

Cardiac Operations

Objective: To evaluate the effect of a new ultrafiltration technique — subzero-balanced ultrafiltration technique — on early postoperative outcomes of adult patients undergoing cardiac operations with cardiopulmonary bypass. Methods: A total of 120 patients who required cardiopulmonary bypass for cardiac surgery were randomized into two groups, 60 in each group. Patients in the treatment group received subzero-balanced ultrafiltration during cardiopulmonary bypass, while patients in the control group received routine cardiopulmonary bypass. Postoperative outcomes, including hospital mortality and morbidity of the two groups, were analyzed. Results: Hospital mortality was 0% (0 of 60) in the treatment group versus 1.8% (1 of 60) in the control group (P=1.000). Total hospital complications was lower in the treated patients (11 of 60 [18.3%] versus 22 of 60 [36.7%], P=0.025). Duration of intubation time was shorter and transfusion volume within 24 hours postoperatively was less in patients having received subzero-balanced ultrafiltration during cardiopulmonary bypass (14.35 ± 1.66 versus 18.64 ± 1.57 h, P=0.036 and 1.54 ± 1.56 versus 3.64 ± 2.67 U/patient, P=0.032). Length of stay on the intensive care unit, duration of hospital stay, need for infusion of inotropic agent and drainage volumes within 24 h postoperatively between the two groups were comparable. Conclusions: Subzero-balanced ultrafiltration during cardiopulmonary bypass can effectively decrease the patients’ hospital morbidity and the volume of blood transfusion: it also may promote early postoperative recovery of patients. Routine application of subzero-balanced ultrafiltration during adult cardiac operations should not be necessary, but the technique should be compared to other techniques, e.g. MUF, in further studies.

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Hyperinsulinemic Normoglycemia during Cardiac Surgery Reduces a Composite of 30-day Mortality and Serious In-hospital Complications

Anesthesiology ◽

10.1097/aln.0000000000002156 ◽

2018 ◽

Vol 128 (6) ◽

pp. 1125-1139 ◽

Cited By ~ 4

Author(s):

Andra E. Duncan ◽

Daniel I. Sessler ◽

Hiroaki Sato ◽

Tamaki Sato ◽

Keisuke Nakazawa ◽

...

Keyword(s):

Cardiac Surgery ◽

Relative Risk ◽

Royal Victoria Hospital ◽

Cleveland Clinic ◽

Weighted Average ◽

Circulatory Support ◽

High Dose ◽

Composite Outcome ◽

Mortality And Morbidity ◽

Glycemic Management

Abstract Background Hyperinsulinemic normoglycemia augments myocardial glucose uptake and utilization. We tested the hypothesis that hyperinsulinemic normoglycemia reduces 30-day mortality and morbidity after cardiac surgery. Methods This dual-center, parallel-group, superiority trial randomized cardiac surgical patients between August 2007 and March 2015 at the Cleveland Clinic, Cleveland, Ohio, and Royal Victoria Hospital, Montreal, Canada, to intraoperative glycemic management with (1) hyperinsulinemic normoglycemia, a fixed high-dose insulin and concomitant variable glucose infusion titrated to glucose concentrations of 80 to 110 mg · dl–1; or (2) standard glycemic management, low-dose insulin infusion targeting glucose greater than 150 mg · dl–1. The primary outcome was a composite of 30-day mortality, mechanical circulatory support, infection, renal or neurologic morbidity. Interim analyses were planned at each 12.5% enrollment of a maximum 2,790 patients. Results At the third interim analysis (n = 1,439; hyperinsulinemic normoglycemia, 709, standard glycemic management, 730; 52% of planned maximum), the efficacy boundary was crossed and study stopped per protocol. Time-weighted average glucose concentration (means ± SDs) with hyperinsulinemic normoglycemia was 108 ± 20 versus 150 ± 33 mg · dl–1 with standard glycemic management, P < 0.001. At least one component of the composite outcome occurred in 49 (6.9%) patients receiving hyperinsulinemic normoglycemia versus 82 (11.2%) receiving standard glucose management (P < efficacy boundary 0.0085); estimated relative risk (95% interim-adjusted CI) 0.62 (0.39 to 0.97), P = 0.0043. There was a treatment-by-site interaction (P = 0.063); relative risk for the composite outcome was 0.49 (0.26 to 0.91, P = 0.0007, n = 921) at Royal Victoria Hospital, but 0.96 (0.41 to 2.24, P = 0.89, n = 518) at the Cleveland Clinic. Severe hypoglycemia (less than 40 mg · dl–1) occurred in 6 (0.9%) patients. Conclusions Intraoperative hyperinsulinemic normoglycemia reduced mortality and morbidity after cardiac surgery. Providing exogenous glucose while targeting normoglycemia may be preferable to simply normalizing glucose concentrations.

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Perubahan kadar hemoglobin akibat terapi kurkuminoid ekstrak rimpang kunyit dibandingkan natrium diklofenak pada penderita osteoartritis

Jurnal Gizi Klinik Indonesia ◽

10.22146/ijcn.17756 ◽

2011 ◽

Vol 7 (3) ◽

pp. 146

Author(s):

Nyoman Kertia ◽

Ahmad Husain Asdie ◽

Wasilah Rochmah ◽

Marsetyawan Marsetyawan

Keyword(s):

Treatment Group ◽

Side Effects ◽

Group Treatment ◽

Educational Level ◽

Diclofenac Sodium ◽

Hemoglobin Level ◽

Treatment Results ◽

Treatment Groups ◽

Natural Medicine ◽

Before And After

Background: In general, patients with osteoarthritis require long live treatments, especially anti-infammatory drugs. Non steroidal anti infammatory drugs are mostly follow by some side effects such as dyspepsia and gastrointestinal bleeding. The use of natural medicine for rheumatic diseases have commonly been practiced worldwide.Objectives: To learn the changes of hemoglobin level due to treatment with curcuminoid from Curcuma domestica Val. rhizome extract compared to diclofenac sodium as anti-infammatory agent for the treatment of osteoarthritis.Methods: This research is a prospective randomized open end blinded evaluations (PROBE). Patients treated with 30 mg curcuminoid from Curcuma domestica Val. rhizome extract or 25 mg diclofenac sodium three times daily for 4 weeks respectively.The hemoglobin level was checked before and after treatment. Results: A total of 80 patients with knee osteoarthritis participated in this study. There was no signifcant difference in the frequency of sex, educational level, duration of suffering, percentage of co-morbidities in both groups. There was no signifcant different of hemoglobin level before treatment between both treatment group. The hemoglobin level was increase signifcantly in curcuminoid treatment groups while no signifcant change in diclofenac group. Treatment with curcuminoid increasing the hemoglobin level signifcantly compare to diclofenac sodium (p=0.03).Conclusion: Treatment with curcuminoid from Curcuma domestica Val. rhizome increasing the hemoglobin level signifcantly compare to diclofenac sodium treatment for osteoarthritis.

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Obvious but Always Ignored: Nutritional Status Affects Cardiac Surgery Mortality

10.22541/au.161212748.80520847/v1 ◽

2021 ◽

Author(s):

Arif Gucu ◽

Ozlem Arican Ozluk ◽

Sadik Ahmet Sunbul ◽

Nail Kahraman ◽

Deniz Demir ◽

...

Keyword(s):

Multivariate Analysis ◽

Cardiac Surgery ◽

Nutritional Status ◽

Hospital Mortality ◽

Prognostic Nutritional Index ◽

Mortality And Morbidity ◽

Nutritional Index ◽

Group I ◽

Group Ii ◽

Index Value

Background: The nutritional status of the patient is an important parameter in patients undergoing surgery. This study aims to determine of prognostic nutritional index value that predicts hospital mortality and morbidity in on-pump cardiac surgery. Methods: In this study, we scanned the medical data of 1003 patients who underwent on-pump cardiac surgery. Patients’ divided into two groups according to in-hospital mortality. 934 patients without in-hospital mortality were defined as Group I, and 69 patients who died in the hospital were defined as Group II. Their preoperative nutritional status was determined using the prognostic nutritional index classification. Results: In our series, age is statistically higher in Group II rather than Group I (62.5 ± 0.3 vs. 67.4 ± 1.2; p=0.001). There was a significantly different a higher tendency of hospital-acquired infection in Group II (151; 16.2% vs. 44; 63.8%; p=0.001). Postoperative stroke significantly higher in Group II (35; 3.7% vs. 62; 89.9%; p=0.001). Multivariate analysis revealed that cross clamp time, cardiopulmonary bypass time, intraaortic balloon pump usage and intensive care unit stay significantly higher in Group II (p<0.05, respectively). The prognostic nutritional index value was found statistically low in Group II (48.34 ± 6.71 vs. 44.76 ± 7.63; p=0.001). Multivariate analysis revealed that male gender, age, and the prognostic nutritional index were independently associated with postoperative survival. Conclusion: In on-pump cardiac surgery, postoperative mortality and morbidity are significantly associated with preoperative low prognostic nutritional index, and the prognostic nutritional index can be a useful and suitable parameter for preoperative risk evaluation.

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