MATERIALS AND METHODS
This retrospective study included a total of 1003 patients who underwent
on-pump cardiac surgery in our institute between January 2016 and
January 2020. The patients’ demographic characteristics, medical
records, laboratory study findings, and clinical outcomes were
retrospectively collected by searching the institutional clinical
database. Surgical procedures included coronary artery bypass grafting
(CABG), aortic valve replacement (AVR), mitral valve replacement (MVR),
and combined procedures (Table1). Peripheral blood samples taken on the
first day of hospitalization for all patients were noted. The whole
blood cell count analysis were performed using Beckmann Coulter LH780
Hematology Analyzer device and Biochemical measurements were performed
using Roche diagnostic Cobas 8000 (Manheim).
Other data, body mass index (BMI), preoperative left ventricular
ejection fraction (LVEF), cross clamp (X-clamp) time, cardiopulmonary
bypass (CPB) time, intraaortic balloon pump (IABP) usage, intensive care
unit (ICU) stays, postoperative hospital-acquired infection and stroke
were noted. We defined six types of infections after cardiac surgery as
hospital-acquired infections Based on O’Keefe et
al.15. These included urinary tract infection,
pneumonia, harvest site infections, superficial sternal wound infection,
deep sternal wound infection, and sepsis. We also noted that stroke
events after surgery. The most commonly used definitions were stroke
observed ’on waking’ or ’after extubation’ for early stroke after a
symptom-free interval for delayed stroke. We used both to describe
postoperative stroke.
The preoperative nutritional status of the patients was assessed using
the PNI classification. PNI was calculated according to the formula: 10
x serum Albumin + 0.005 x total lymphocyte count (as previously
described)13.
The study protocol was approved by the Bursa Yuksek Ihtisas Training and
Research Hospital Ethics Committee (2011-KAEK-25 2020/03-11). The
informed consent requirement was renounced due to the retrospective
nature of the study.