The Effect of Birth Month on the Risk of Deep Sternal Wound Infections in Patients After Coronary Artery Bypass Grafting and Heart Defect Surgery.

BACKGROUND: Cardiovascular diseases remain one of the leading causes of morbidity and mortality worldwide, however its surgical treatment remains risky with possible complications. There is increasing evidence that the month of birth (MOB) has been related to different health problems during life. The aim of this study was to identify the effect of MOB on the risk of deep sternal wound infections (DSWI) in patients after open-heart surgery. METHODS: The follow-up retrospective research was performed at the Department of Thoracic, Cardiac, and Vascular Surgery of the Hospital of Lithuanian University of Health Sciences. We analyzed the MOB of 201 patients, who underwent open-heart surgery between January 2017 and December 2018. The case group consisted of 46 patients, who suffered from DSWI. Multivariate logistic regression for the association between MOB and risk of DSWI was used. RESULTS: The results showed that the risk of DSWI was by four times higher for patients born in June-September months. The risk of developing DSWI in the case group was even higher for women, patients aged 70 years and younger, those overweight or obese, and patients who underwent only CABG surgery. CONCLUSION: Due to the growing evidence that the month of birth affects the onset of diseases, it is important to assess MOB as the potential risk factor for developing DSWI.

Association between serum biomarkers and postoperative delirium after cardiac surgery.

BACKGROUND: In cardiac surgery, patients face an increased risk of developing postoperative delirium (POD) that is associated with poor outcomes. Neuron-specific enolase (NSE) and glial fibrillary acidic protein (GFAP) have shown some promising results as potential tools for POD risk stratification, diagnosis, monitoring, and prognosis. MATERIALS AND METHODS: Prospective single-centre study enrolled 44 patients undergoing elective coronary artery bypass grafting (CABG) and/or valve procedures using cardiopulmonary bypass (CPB). The patients were assessed and monitored preoperatively, during surgery, and in the early postoperative period. The blood levels of NSE and GFAP were measured before and after surgery. The early POD was assessed by CAM-ICU criteria and patients were assigned to the POD group (with POD) or to the NPOD group (without POD) retrospectively. RESULTS: The incidence of POD was 18.2%. After surgery, NSE significantly increased in the whole sample (p = 0.002). Comparing between groups, NSE significantly increased in the POD group after surgery (p = 0.042). ΔGFAP (before/after operation) for the whole sample was statistically significant (p = 0.022). There was a significant correlation between ΔGFAP and the lowest MAP during surgery in the POD group (p = 0.033). CONCLUSIONS: Our study demonstrated that NSE and GFAP are associated with early POD. An increase in NSE level during the perioperative period may be associated with subclinical neuronal damage. Serum GFAP levels show the damage of glial cells. Further studies are needed to find the factors influencing the individual limits of optimal MAP during surgery.