Comparison of some parameters in estimating in-hospital mortality risk in patients undergoing open-heart surgery.

OBJECTIVE: Despite accumulating evidence showing the importance of various scoring systems in predicting preoperative mortality rates among patients who are undergoing open cardiac surgery, the prediction of in-hospital mortality is still limited. This study aimed to investigate the contributing factors associated with in-hospital mortality in patients who undergo cardiac surgery. PATIENTS AND METHODS: All patients, aged 19 to 80 years, who underwent cardiac surgery between February 2019 and November 2020 at our tertiary healthcare institute were analyzed retrospectively. Demographic details, transthoracic echocardiography data, operation-related details, cardiopulmonary bypass time and laboratory measurement results were retrieved from the institutional digital database. RESULTS: Data was available for a total of 311 subjects whose median age was 59 (52-67) years, and 65% of which were male. Among these 311 subjects, 296 (95%) were successfully discharged; however, in-hospital mortality was observed in 15 (5%) patients. Multiple logistic regression analysis revealed that low ejection fraction (p=0.049 and p=0.018), emergency surgery (p=0.022), low postoperative platelet (p=0.002) and high postoperative creatinine (p=0.007) were the most significant risk factors of mortality. CONCLUSIONS: In conclusion, in a population of subjects undergoing cardiac and thoracic surgery, the in-hospital mortality rate was 4.8%. Left ventricular ejection fraction (LVEF) <40%, emergency surgery, postoperative platelet count and postoperative creatinine were significant risk factors for mortality.

Containment measures established during the COVID-19 outbreak and its impact on lipid profile and neutrophil to lymphocyte ratio.

OBJECTIVE: Almost all countries announced social restrictions and distancing measures which could unintentionally lead to a decline in admissions to hospital for acute disorders other than signs of pneumonia. We aimed to evaluate lipid profile, neutrophil to lymphocyte ratio (NLR) and cardiovascular admissions to the coronary care unit (CCU) of a tertiary center in Turkey during the COVID-19 era and to compare these results with admissions in the same time interval of the previous year. MATERIALS AND METHODS: We retrospectively analyzed CCU admissions due to new-onset atrial fibrillation, ST-elevation myocardial infarction, non-ST elevation acute coronary syndrome (NSTEACS) and acute heart failure during the COVID-19 outbreak and the same time interval of the past year. Laboratory measurements including lipid profile and NLR values were retrieved from the institutional digital database. RESULTS: Compared to the same time interval of 2019 (March-April, 2019), the number of patients admitted to the CCU with acute cardiovascular disorders (atrial fibrillation, STEMI, NSTEACS and acute heart failure) were lower in the COVID-19 period. The levels of NLR, total cholesterol, and low-density lipoprotein (LDL) cholesterol were significantly higher and high-density lipoprotein (HDL) cholesterol was significantly lower in subjects admitted to the CCU during March-April 2020 compared to subjects admitted in March-April 2019. CONCLUSIONS: Our findings show that subjects admitted to the CCU in the COVID-19 era have an unfavorable lipid profile and elevated NLR compared to those admitted in 2019. These patients appear to be at high risk for future cardiovascular events.