Kardiyopulmoner bypass eşliğinde izole koroner arter bypass ameliyatı yapılan hastalarda inflamasyon parametreleri ile postoperatif yeni gelişen atrial fibrilasyon ilişkisi
Küçük Resim Yok
Tarih
2022
Yazarlar
Dergi Başlığı
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Cilt Başlığı
Yayıncı
İnönü Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: İnflamasyon ile postoperatif atriyal fibrilasyon (POAF) ilişkisine dair farklı sonuçların yayınlandığı çalışmalar mevcuttur. Literatürden farklı olarak çalışmamızda daha fazla inflamasyon biyobelirteci kullanılarak POAF inflamasyon ilişkisini ortaya koymak ve inflamasyon parametrelerinin POAF öngörmedeki gücünü araştırmak amaçlanmaktadır. Gereç ve yöntem: KPB altında izole KABC yapılan 191 hasta çalışmaya alındı. Hastalar, POAF gelişen olgular (grup 1, n=71) ve gelişmeyen olgular (grup 2, n=120) olarak iki gruba ayrıldı. Hastaların preoperatif, postoperatif ikinci ve dördüncü gün inflamasyon parametrelerindeki değişim ve farklılıklar risk analizleriyle değerlendirildi. Bulgular: Gruplar arasında demografik ve peroperatif parametrelerden yaş (p=0,038), vücut kitle indeksi (p=0,01), vücut yüzey alanı (p=0,009), PAB (p=0,018), postoperatif drenaj miktarında (p<0,001) istatistiksel farklılık bulundu. POAF grubunda, RDW postoperatif ikinci (p<0,001) ve dördüncü (p=0,005) günlerde anlamlı azalma ve postoperatif dördüncü gün NLR'de anlamlı artış (p=0,026) görüldü. Multivariate lojistik regresyon analizinde postoperatif RDW azalması (p<0,001, OR:0,835) ve PLC-R artışı (p=0,034, OR:1,049) POAF risk faktörü olarak tespit edildi. Diğer inflamasyon parametreleri anlamlı farklılık göstermedi ve risk faktörü tespit edilmedi. Sonuç: Çalışmamıza dahil edilen 17 inflamasyon biyobelirteçinden RDW, NLR ve PLC-R POAF prediktörü tespit edildi. İnflamasyonun POAF patofizyolojisinde etkili olduğu düşünülmekte ancak ilişkilerine dair farklı sonuçların yayınlandığı çalışmalar mevcuttur. Büyük hasta sayıları ve çok merkezli çalışmalarla bu ilişkinin daha net ortaya konması ile gelecekte POAF proflaksisinde anti inflamatuvar tedavinin gündeme gelebileceği ve POAF komplikasyonlarından korunmanın mümkün olabileceği kanaatindeyiz.
Objective: Different results reported regarding relationship between inflammation and POAF. Unlike the literature, this study aimed to reveal the relationship between POAF and inflammation by using many inflammation biomarkers and to investigate the power of inflammation parameters in predicting POAF. Materials and methods: One hundred ninety-one patients who underwent isolated CABG surgery with CPB were included in study. Patients were divided into two groups developing POAF (group 1, n=71) and non-developing (group 2, n=120). Changes and differences in inflammation parameters between groups preoperatively, postoperatively second and fourth-day were evaluated by risk analysis. Results: Demographic and peroperative parameters of age (p=0.038), body mass index (p=0.01), body surface area (p=0.009), pulmonary artery pressure (p=0.018), postoperative drainage (p<0.001) revealed a statistical difference between groups. POAF group revealed significant decrease in RDW on second (p<0.001) and fourth (p=0.005) postoperative days, a significant increase in NLR on fourth postoperative day (p=0.026). Multivariate logistic regression analysis revealed postoperative RDW decrease (p<0.001, OR:0.835) and PLC-R increase (p=0.034, OR:1.049) were POAF risk factors. Other inflammation parameters showed no significant difference and no risk factor was identified. Conclusion: Among 17 inflammation biomarkers included in study RDW, NLR, PLC- R were detected as predictors of POAF. Inflammation is thought to be effective in pathophysiology of POAF, but studies have published conflicting results regarding their relationship. Multicenter studies with large patient numbers can reveal this relationship more clearly and we believe that anti-inflammatory treatment in POAF prophylaxis may come to the fore in future and so prevention of POAF complications may possible.
Objective: Different results reported regarding relationship between inflammation and POAF. Unlike the literature, this study aimed to reveal the relationship between POAF and inflammation by using many inflammation biomarkers and to investigate the power of inflammation parameters in predicting POAF. Materials and methods: One hundred ninety-one patients who underwent isolated CABG surgery with CPB were included in study. Patients were divided into two groups developing POAF (group 1, n=71) and non-developing (group 2, n=120). Changes and differences in inflammation parameters between groups preoperatively, postoperatively second and fourth-day were evaluated by risk analysis. Results: Demographic and peroperative parameters of age (p=0.038), body mass index (p=0.01), body surface area (p=0.009), pulmonary artery pressure (p=0.018), postoperative drainage (p<0.001) revealed a statistical difference between groups. POAF group revealed significant decrease in RDW on second (p<0.001) and fourth (p=0.005) postoperative days, a significant increase in NLR on fourth postoperative day (p=0.026). Multivariate logistic regression analysis revealed postoperative RDW decrease (p<0.001, OR:0.835) and PLC-R increase (p=0.034, OR:1.049) were POAF risk factors. Other inflammation parameters showed no significant difference and no risk factor was identified. Conclusion: Among 17 inflammation biomarkers included in study RDW, NLR, PLC- R were detected as predictors of POAF. Inflammation is thought to be effective in pathophysiology of POAF, but studies have published conflicting results regarding their relationship. Multicenter studies with large patient numbers can reveal this relationship more clearly and we believe that anti-inflammatory treatment in POAF prophylaxis may come to the fore in future and so prevention of POAF complications may possible.
Açıklama
Anahtar Kelimeler
Göğüs Kalp ve Damar Cerrahisi, Thoracic and Cardiovascular Surgery
