Koyuncu Ilhan, Koyun Emin
IDepartment of cardiology, Izmir Bakircay University, Izmir, Türkiye.
Sivas Numune Hospital, Sivas, Türkiye.
Front Nutr. 2024 Nov 1;11:1489301. doi: 10.3389/fnut.2024.1489301. eCollection 2024.
Coronary heart disease (CHD) is the most common cause of cardiovascular disease (CVD). CHD is among the most common causes of mortality and morbidity world wide. In addition, CHD is one of the most important causes of health expenditures world wide. Today, coronary artery bypass grafting (CABG) operations are a widely used surgical procedure and have an important place in the treatment of CHD. Many scoring systems have been evaluated to estimate the risk of mortality and morbidity. 30-day mortality rates after CABG have been reported as 1-4% in large-scale studies.
The aim of our study was to evaluate the relationship between 1-month mortality in patients undergoing CABG and the Hemoglobin, albumin, lymphocyte, platelet index (HALP score) and Prognostic nutritional index (PNI) calculated using laboratory data in the preoperative period.
A total of 239 patients who underwent CABG were evaluated retrospectively. Preoperative biochemical and hemogram values, demographic characteristics, comorbidities, HALP score and PNI values of the patients were recorded. The patients were divided into two groups: Exitus group ( = 51) and survival group ( = 188). The data of the two groups were compared, mainly HALP score and PNI.
It was observed that 51 of 239 patients (21.3%) developed exitus during the 30-day follow-up after CABG. When demographic data are compared; advanced age, female gender, history of DM (Diabetes Mellitus), history of HL (hyperlipidemia) and smoking were found to be associated with mortality. When laboratory data are compared; high troponin levels, low hemoglobin, low lymphocyte and low albumin levels were found to be associated with mortality. Low HALP score ( < 0.001) and low PNI ( < 0.001) were also found to be associated with mortality. In univariate and multivariate regression analysis; advanced age, history of DM, HALP score and PNI were found to be independent predictors of 30-day mortality after CABG. It was determined that a cut-off value of 0.29 for the HALP score and 39.1 for PNI had found, respectively, 81 and 79% sensitivity and 82 and 80% specificity.
Preoperatively measured HALP score and PNI can be used to predict 1-month mortality after CABG.
冠心病（CHD）是心血管疾病（CVD）最常见的病因。冠心病是全球范围内最常见的死亡和发病原因之一。此外，冠心病是全球医疗支出的最重要原因之一。如今，冠状动脉旁路移植术（CABG）手术是一种广泛应用的外科手术，在冠心病的治疗中占有重要地位。许多评分系统已被评估用于估计死亡和发病风险。大规模研究报告CABG术后30天死亡率为1%-4%。
我们研究的目的是评估接受CABG手术患者的1个月死亡率与术前通过实验室数据计算的血红蛋白、白蛋白、淋巴细胞、血小板指数（HALP评分）和预后营养指数（PNI）之间的关系。
对总共239例接受CABG手术的患者进行回顾性评估。记录患者的术前生化和血常规值、人口统计学特征、合并症、HALP评分和PNI值。患者分为两组：死亡组（n = 51）和存活组（n = 188）。比较两组的数据，主要是HALP评分和PNI。
观察到239例患者中有51例（21.3%）在CABG术后30天随访期间死亡。比较人口统计学数据时；高龄、女性、糖尿病史、高脂血症史和吸烟被发现与死亡率相关。比较实验室数据时；高肌钙蛋白水平、低血红蛋白、低淋巴细胞和低白蛋白水平被发现与死亡率相关。低HALP评分（<0.001）和低PNI（<0.001）也被发现与死亡率相关。在单因素和多因素回归分析中；高龄、糖尿病史、HALP评分和PNI被发现是CABG术后30天死亡率的独立预测因素。确定HALP评分的临界值为0.29，PNI的临界值为39.1，分别具有81%和79%的敏感性以及82%和80%的特异性。
术前测量的HALP评分和PNI可用于预测CABG术后1个月死亡率。
