Çakırköse Özlem, Muhtaroğlu Ali, Kuloglu Ersin
Department of Cardiovascular Surgery, Giresun University Faculty of Medicine, Giresun, TUR.
Department of General Surgery, Giresun University Faculty of Medicine, Giresun, TUR.
Cureus. 2024 Jul 26;16(7):e65456. doi: 10.7759/cureus.65456. eCollection 2024 Jul.
Coronary bypass surgery remains a cornerstone treatment for advanced coronary artery disease. Identifying reliable predictors of postoperative mortality can significantly enhance patient care and outcomes. This study investigates the prognostic value of preoperative and postoperative amylase levels, creatinine, alanine aminotransferase, and aspartate aminotransferase as mortality markers in coronary bypass surgery patients.
We conducted a retrospective analysis of 343 patients who underwent coronary bypass surgery. We compared the preoperative and postoperative biochemical markers (amylase, creatinine, alanine aminotransferase, and aspartate aminotransferase) of patients who died within the first week post-surgery (n = 52) and those who survived (n = 291). Statistical analyses included chi-square tests for categorical variables, t-tests for continuous variables, and receiver operating characteristic analysis for predicting mortality.
No significant difference was observed in the distribution of blood groups between deceased and surviving patients. However, significant differences were noted in gender distribution and mean ages, with higher mortality observed in older and male patients. Preoperative creatinine levels were significantly higher in patients who died compared to survivors. Postoperatively, deceased patients exhibited significantly higher levels of amylase, creatinine, alanine aminotransferase, and aspartate aminotransferase. Receiver operating characteristic analysis revealed that postoperative amylase, creatinine, alanine aminotransferase, and aspartate aminotransferase values were good predictors of mortality, with amylase being the most significant predictor.
This study highlights the importance of biochemical markers, particularly amylase, as predictors of mortality in patients undergoing coronary bypass surgery. The findings suggest that monitoring and managing amylase, creatinine, alanine aminotransferase, and aspartate aminotransferase levels pre- and post-surgery could improve patient outcomes. This study lays the groundwork for further research into the mechanistic links between these biochemical markers and patient survival, potentially leading to improved prognostic tools and therapeutic strategies.
冠状动脉搭桥手术仍然是晚期冠状动脉疾病的基石性治疗方法。识别术后死亡率的可靠预测指标可显著改善患者护理及治疗结果。本研究调查术前和术后淀粉酶水平、肌酐、丙氨酸转氨酶和天冬氨酸转氨酶作为冠状动脉搭桥手术患者死亡率标志物的预后价值。
我们对343例行冠状动脉搭桥手术的患者进行了回顾性分析。我们比较了术后第一周内死亡患者（n = 52）和存活患者（n = 291）的术前和术后生化指标（淀粉酶、肌酐、丙氨酸转氨酶和天冬氨酸转氨酶）。统计分析包括分类变量的卡方检验、连续变量的t检验以及预测死亡率的受试者工作特征分析。
死亡患者和存活患者的血型分布无显著差异。然而，性别分布和平均年龄存在显著差异，老年患者和男性患者的死亡率更高。与存活患者相比，死亡患者的术前肌酐水平显著更高。术后，死亡患者的淀粉酶、肌酐、丙氨酸转氨酶和天冬氨酸转氨酶水平显著更高。受试者工作特征分析显示，术后淀粉酶、肌酐、丙氨酸转氨酶和天冬氨酸转氨酶值是死亡率的良好预测指标，其中淀粉酶是最显著的预测指标。
本研究强调了生化指标，尤其是淀粉酶，作为冠状动脉搭桥手术患者死亡率预测指标的重要性。研究结果表明，监测和管理手术前后的淀粉酶、肌酐、丙氨酸转氨酶和天冬氨酸转氨酶水平可改善患者治疗结果。本研究为进一步研究这些生化指标与患者生存之间的机制联系奠定了基础，可能会带来更好的预后工具和治疗策略。
