Are preoperative elevated Inflammation parameters predictive for mortality in isolated coronary artery by pass surgery (CABG)

Objective: It is shown that preoperative elevated inflammation markers can be used as a predictor of atherosclerosis. but the value of these markers as never been studied during the post operative period

this study was undertaken to see if these markers have a impact on post operative complication and outcome.

Methods: In this retrospective study the value of preoperative C Reactive Protein(CRP) and White Cell Count (WBC) elevation were analyzed in all patients undergoing CABG during a period between 01.01. 2005 and 31.12.2009 in our centre. 933 patients.

Results: Significant correlation between CRP elevation and prolonged intensive unite care unit stay (ICU), (p<0.001) prolonged ventilation time (p<0.001), prolonged hospital stay (p<0.001), increased erythrocytes transfusion (p<0.001), increased renal insufficiency (p=<0.001), post operative infection (p<0.001) and mortality (p<0.025).

We are also be able to see a significant correlation between preoperative WBC elevation and prolonged ICU stay (p<0.001), CK MB (p<0.001), increased erythrocytes transfusion (p<0.001), infection rate (p<0.001), use of Intra-aortic balloon pump (IABP) (p<0.001), neurological complication (p=<0.031) renal insufficiency p<0.001) and mortality (p<0.001).

Taking in account all the variables CRP was independent risk for increase prolonged ICU days (p<0.001) increased ventilation time (p<0.001), hospital stay (p<0.001) and ck MB (p<0.018).

Conclusion: Inflammation parameters such as CRP and WBC are an important predictive markers for post operative complications and outcome. Elective CABG cases have to be operated only in patients with no elevated preoperatively inflammation markers.