Department of Anesthesia and Intensive Care, University of Debrecen, Medical and Health Science Centre, 4032 , Nagyerdei krt. 98, Debrecen, Hungary.
J Anesth. 2012 Dec;26(6):812-21. doi: 10.1007/s00540-012-1454-y. Epub 2012 Jul 31.
The authors intended to test their hypothesis that a low blood selenium level is associated with higher mortality, morbidity, and increased inflammatory response following cardiac surgery.
A single-center clinical survey was conducted on 197 consecutive patients undergoing on-pump operation in Debrecen, Hungary. Blood samples for whole blood selenium analysis were taken immediately before the surgery. Their risk profiles were evaluated according to the EuroSCORE. The outcome parameters were as follows: 30-day mortality, incidence of systemic inflammatory response syndrome, and cardiac and renal dysfunction. The main laboratory outcome variables were the postoperative concentrations of C-reactive protein and cardiac troponin I.
The mean blood selenium level was significantly lower in non-survivors 102.2 ± 19.5 μg/L compared with survivors 111.1 ± 16.9 μg/L (p = 0.047), and the mean age, EuroSCORE values, and troponin concentrations were significantly higher in the non-survivors. To exclude these potential confounders a logistic regression model was fitted to our data, with mortality as the outcome and the EuroSCORE, the degree of troponin elevation, and selenium concentration as explanatory variables. This model revealed that a lower selenium level was a minor but apparently existing risk factor for postoperative mortality.
Further examinations are required to clarify the question that remained unanswered in this study: the role of low selenium in the causality chain leading to higher postoperative mortality.
作者旨在检验其假设，即低血硒水平与心脏手术后死亡率、发病率升高和炎症反应增加有关。
在匈牙利德布勒森的 197 例连续接受体外循环手术的患者中进行了一项单中心临床调查。在手术前立即采集全血硒分析的血样。根据 EuroSCORE 评估他们的风险状况。研究的结果参数如下：30 天死亡率、全身炎症反应综合征的发生率以及心脏和肾功能障碍。主要实验室结果变量是术后 C 反应蛋白和肌钙蛋白 I 的浓度。
非幸存者的平均血硒水平明显低于幸存者（102.2 ± 19.5 μg/L 比 111.1 ± 16.9 μg/L，p = 0.047），且非幸存者的平均年龄、EuroSCORE 值和肌钙蛋白浓度明显更高。为了排除这些潜在的混杂因素，我们将逻辑回归模型拟合到我们的数据中，以死亡率为结果，以 EuroSCORE、肌钙蛋白升高程度和硒浓度为解释变量。该模型表明，低硒水平是术后死亡率的一个较小但明显存在的危险因素。
需要进一步的检查来阐明本研究中未回答的问题：低硒在导致术后死亡率升高的因果链中的作用。
