Abstract
The aim of our study was to analyze the effect of individual preoperative and intraoperative parameters, as well as the level of the cytokine interleukin-8 (IL-8), on the likelihood of postcardiotomy syndrome during the correction of valvular pathology.
Material and methods. The study includs 59 patients who were admitted to the department of surgery for acquired heart diseases of the. The average age of patients was 54 years (18–78 years), of which: women – 26 and men – 33. The examination of patients was carried out according to standard methods. The analysis of risk factors for the development of postcardiotomy syndrome included: gender, age (under 40 years old, from 40 to 70 and over 70 years old), decreased contractile function of the left ventricular myocardium (less than 50%), low hemoglobin level (less than 120 g/l), etiology of the disease (rheumatic fever, infective endocarditis), concomitant ischemic heart disease with coronary artery bypass grafting, interleukin-8 index in the preoperative period (low < 21 pg/ml, increased > 62 pg/ml). The data were processed by the method of variation statistics.
Results. Selected factors such as gender, young age, obesity, etiology of the defect, interleukin-8 index less than 21 pg/ml did not matter for the development of the syndrome, and the hazard ratio (HR) was within 1 at 95% confidencial interval (CI). For patients over 70 years of age, the relative risk of postpericardiotomy syndrome was 2.12. The risk of developing postcardiotomy syndrome increased almost 5 (4.72) times if the hemoglobin level before surgery was below 120 g/L. The presence of concomitant coronary artery disease and coronary artery bypass grafting increased the relative risk to 14.15 (95% CI, p = 0.0001). The combination of low hemoglobin and low IL-8 increased the HR to 7.08, and the combination of low IL-8 and coronary artery bypass grafting showed an even higher HR of 24.77 (p = 0.0005).
Conclusions. The study is limited to a small group of patients. We did not find the influence of a low IL-8 index (less than 21 pg/ml) as a separate factor influencing the development of postcardiotomy syndrome. The most significant risk factor was coronary artery bypass grafting, which was performed simultaneously with correction of valvular pathology (HR 14.15–95% CI), a combination of a low IL-8 index and a low hemoglobin index (HR 7.08), a combination of a low IL-8 and concomitant coronary artery bypass grafting 24.77 (95% CI, p = 0.0005).
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About the authors
- Svetlana I. Babenko, Dr. Med. Sc., Senior Researcher, ORCID
- Roman I. Amiragov, Cand. Med. Sc., Junior Researcher, ORCID
- Anton S. Sachkov, Cand. Med. Sc., Researcher, ORCID
- Ravil’ M. Muratov, Dr. Med. Sc., Professor, Head of the Department, ORCID
