Investigation of the Effect of Preoperative Hypoalbuminemia, Blood Urea Nitrogen and Creatinine Levels on Postoperative Atrial Fibrillation on Off-Pump Coronary Bypass Surgery Patients

Akgül, Engin; Parlar, Ali İhsan; Erkul, Gulen Sezer Alptekin; Erkul, Sinan; Çekirdekçi, Ahmet

doi:10.1532/hsf.3163

Cited by 9 publications

(9 citation statements)

References 33 publications

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“…In a study by Yayla et al [14], albumin levels were found to be significantly lower in patients who developed saphenous vein occlusion after CABG operations. In other studies, significant correlations were found between atrial fibrillation developing after cardiac surgery and low albumin [15,16]. In our study, we found that albumin levels at the time of pneumonia diagnosis were low in patients who developed mortality, although it was not statistically significant (p = 0.076).…”

Section: Discussioncontrasting

confidence: 47%

“…This value is an important parameter indicating the state of dehydration in individuals and has been associated with poor clinical outcomes in patients with heart failure and pneumonia [9,17]. In a study by Akgül et al [16], a significant relationship was found between the development of postoperative atrial fibrillation, which is closely related to inflammation, and high BUN values after CABG operations. In our patients, BUN values at the time of diagnosis of pneumonia were significantly higher in the mortality group (p = 0.004).…”

Section: Discussionmentioning

confidence: 99%

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Can the blood urea nitrogen to serum albumin ratio be used as a mortality predictor in patients with pneumonia after cardiac surgery?

Pala

Güvenç

et al. 2022

The European Research Journal

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Objectives: Serious complications are seen after cardiac surgery operations. Postoperative pneumonia is one of the most important of these complications. Some biomarkers have been examined in the prediction of mortality in special groups such as hospital-acquired pneumonia or aspiration pneumonia. In addition to parameters such as blood-urea nitrogen and albumin, the blood urea nitrogen to albumin ratio obtained by the ratio of these two parameters is also used as a mortality predictor. In this study, it was aimed to investigate the effect of the blood urea nitrogen to albumin ratio at the time of diagnosis of pneumonia on mortality in patients who developed pneumonia in the early period after cardiac surgery. Methods: In this study, 138 patients who developed pneumonia in the early period after cardiac surgery were examined. Complete blood count and biochemical test results were analyzed for all patients, and differences between groups were investigated. The patients who developed in-hospital pneumonia and were discharged as survivors were classified as Group 1, and non-survivor patients were determined as Group 2. Results: Patients who did not develop in-hospital mortality were included in Group 1 (n = 105, mean age = 63.7 ± 9.2 years), and those with non-survivor were included in Group 2 (n = 33, mean age = 66.9 ± 9.6 years). At the time of diagnosis neutrophil-lymphocyte ratio, C-reactive protein, blood-urea nitrogen and blood urea nitrogen to albumin ratio values were significantly higher in Group 2 (p < 0.001, p < 0.001, p = 0.004 and p < 0.001; respectively) ROC curve analysis was performed to evaluate blood urea nitrogen to albumin ratio in predicting mortality. The cut-off value of blood urea nitrogen to albumin ratio was 4.1 (Area under the curve [AUC]: 0.740, 95% CI: 0.690-0.820, p < 0.001, with sensitivity of 72.5% and specificity of 68.6%). Conclusions: In pneumonia developing after cardiac surgery, we found that the peripheral blood blood urea nitrogen to albumin ratio at the time of the first symptom in the patient has a high predictive power for the development of mortality in this particular patient group.

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Section: Discussioncontrasting

confidence: 47%

Section: Discussionmentioning

confidence: 99%

Can the blood urea nitrogen to serum albumin ratio be used as a mortality predictor in patients with pneumonia after cardiac surgery?

Pala

Güvenç

et al. 2022

The European Research Journal

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“…A study of 395 patients with stage 3 to 5 chronic kidney disease reported that enlarged LA diameter and hypoalbuminemia were independent predictors of the deterioration of renal function assessed by estimated glomerular filtration rate (eGFR) [ 42 ]. Akgul et al [ 43 ] recently reported that patients with postoperative atrial fibrillation (PoAF) had higher BUN and Cr compared to the PoAF(−) group. They suggested that BUN and Cr levels were predictors of postoperative atrial fibrillation after off-pump cardiopulmonary bypass grafting surgery.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Patients with Angiographically-Confirmed Coronary Artery Disease to Investigate the Association Between Epicardial Fat Thickness and Atrial Fibrillation

Ren

Wang

et al. 2022

Med Sci Monit

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Background Epicardial fat thickness (EFT) is increasingly recognized as an independent risk factor of the presence, severity, and recurrence of atrial fibrillation (AF). We investigated the associations between EFT and AF prevalence and identified its correlation with other risk factors. Material/Methods A total of 199 participants who underwent coronary angiography and had confirmed coronary artery disease (CAD) were enrolled in this study. The EFT was measured by echocardiography and the association of EFT with other AF risk factors was evaluated by multivariate logistic regression analysis. Results The EFT was significantly higher in patients with comorbidity of AF and CAD than those with CAD alone (6.86±1.96 mm vs 5.91±1.71 mm, P <0.001). Logistic regression analysis indicated that EFT was a predictive factor of the occurrence of AF in CAD, after adjusting for body mass index (BMI), systolic blood pressure (SBP), left circumflex artery (LCX) stenosis, LA diameter, B-type natriuretic peptide (BNP), creatinine (Cr), and blood urea nitrogen (BUN). LA diameter, SBP, and LCX stenosis are also independent risk factors for CAD complicated by AF. Correlation analysis revealed significant positive linear correlations between EFT and BMI ( P <0.01), EFT, and LA diameter ( P <0.05), as well as positive correlations between LA diameter and BNP, Cr, or BUN. Conclusions Epicardial fat thickness is a strong predictor for AF prevalence in patients with CAD, independent of other AF risk factors such as LA diameter, BMI, and SBP, while LA diameter, SBP, and LCX stenosis are also independent AF risk factors for CAD.

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“…Due to age-related physiological changes and the effect of anemia, these patients may be more susceptible to hypoxia. Preoperative low albumin was reported to be a risk factor for the development of postoperative atrial fibrillation in elderly patients with off-pump cardiac surgery [17] . Another study suggested that low hemoglobin and albumin scores were not associated with postoperative atrial fibrillation, ventricular fibrillation, or asystole [11] .…”

Section: Discussionmentioning

confidence: 99%

Morbidity and Mortality Markers in Elderly Patients with Cardiovascular Surgery

Özay¹,

Salman²,

Demir³

et al. 2021

GKDA Derg

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Objective: In recent years, as a result of increased average longevity, the number of hospitalized elderly patients has been increasing. Today, although many parameters are used to determine the prognosis of hospitalized patients, more specific information about elderly patients is required. This study aims to investigate the effect of preoperative and postoperative parameters on postoperative complications and mortality among patients aged 65 and over who underwent cardiovascular surgery. Methods: Demographic data, preoperative and postoperative hemoglobin, neutrophil/lymphocyte ratio, mean platelet volume, erythrocyte distribution width, platelet, glucose, urea, creatinine, albumin values and postoperative data were recorded. Results: When the preoperative risk factors for postoperative complications and mortality were evaluated, low preoperative hemoglobin and albumin values and high blood urea and glucose levels were statistically significant (p <0.005). Low postoperative hemoglobin, albumin values, platelet counts, and and high glucose, urea and creatinine values were found to be significant markers of postoperative complications (p <0.005). When preoperative risk factors were evaluated in terms of postoperative 30-day mortality, preoperatively decreased hemoglobin and albumin, increased urea , decreased postoperative hemoglobin, albumin levels, platelet counts, and increased glucose, urea and creatinine values were statistically significant (p <0.005). Conclusion:We believe that closely monitoring the nutritional status of elderly patients, providing them with dietary supplementation for deficient parameters, and keeping blood glucose, urea, and creatinine at optimum levels could help us to decrease hospital stay, mortality-morbidity, and total economic cost.

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Investigation of the Effect of Preoperative Hypoalbuminemia, Blood Urea Nitrogen and Creatinine Levels on Postoperative Atrial Fibrillation on Off-Pump Coronary Bypass Surgery Patients

Cited by 9 publications

References 33 publications

Can the blood urea nitrogen to serum albumin ratio be used as a mortality predictor in patients with pneumonia after cardiac surgery?

Can the blood urea nitrogen to serum albumin ratio be used as a mortality predictor in patients with pneumonia after cardiac surgery?

Evaluation of Patients with Angiographically-Confirmed Coronary Artery Disease to Investigate the Association Between Epicardial Fat Thickness and Atrial Fibrillation

Morbidity and Mortality Markers in Elderly Patients with Cardiovascular Surgery

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