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. 2024 Feb 7:17:755-764.
doi: 10.2147/JIR.S449795. eCollection 2024.

High Preoperative Systemic Immune-Inflammation Index Values Significantly Predicted Poor Outcomes After on-Pump Coronary Artery Bypass Surgery

I Made Adi Parmana  1 , Cindy Elfira Boom  1 , Herdono Poernomo  1 , Chairil Gani  1 , Budi Nugroho  1 , Riza Cintyandy  1 , Lisa Sanjaya  1 , Yudi Hadinata  1 , Dian Raseka Parna  1 , Mefri Yulia  1 , Dudy Arman Hanafy  2
Affiliations

High Preoperative Systemic Immune-Inflammation Index Values Significantly Predicted Poor Outcomes After on-Pump Coronary Artery Bypass Surgery

I Made Adi Parmana et al. J Inflamm Res. .

Abstract

Purpose: On-pump coronary artery bypass grafting (CABG) is one of the most common revascularization surgical therapies for coronary artery disease (CAD). However, owing to the use of cardiopulmonary bypass ("on-pump"), the body develops systemic inflammatory response syndrome, which leads to the risk of morbidity and mortality. This study aimed to determine the perioperative outcomes of patients who underwent on-pump CABG surgery using the systemic immune-inflammation index (SII).

Patients and methods: This single-center retrospective study used secondary data from patients' electronic medical records and medical records archives at the National Cardiovascular Center Harapan Kita, who underwent on-pump CABG from January 2019 to December 2022. A total of 1056 on-pump CABG procedures were performed after exclusion. Lymphocyte, segmental neutrophil, and platelet counts from the preoperative data were used to calculate the SII values. An SII cutoff value of 528.715 × 103/mm3 divided the patients into two groups.

Results: The SII value of 1056 patients were calculated, among which 490 (46%) patients had a preoperative SII value of ≥528.715 × 103/mm3. Multivariate analysis showed that a high SII significantly prolonged the duration of surgery (OR 1.005, 95% CI 1.003-1.006) and cardiopulmonary bypass (CPB) time (OR 1.007, 95% CI 1.005-1.009). High SII values significantly predicted prolonged mechanical ventilation (OR 6.154, 95% CL 3.938-9.617), intensive care unit (ICU) stay (OR 6.332, 95% CL 4.232-9.474), and hospital stay (OR 3.517, 95% CL 2.711-4.562). Regarding other perioperative outcomes, a high SII significantly predicted the risk of postoperative atrial AF, cardiac arrest, acute myocardial infarction, and mortality.

Conclusion: A high preoperative SII value can predict morbidity and mortality in patients undergoing on-pump CABG surgery.

Keywords: morbidity; mortality; on-pump coronary artery bypass graft; systemic immune-inflammation index; systemic inflammation.

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Conflict of interest statement

The authors declare no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Flow chart of study population selection.
Figure 2
Figure 2
Receiver Operating Characteristic (ROC) curve for prediction of poor outcome based on SII. The highest area under the curve of 0.669 (p = <0.001*) for SII, with its respective cutoff value of 528.715×103 /mm3. Poor outcomes were defined as ≥ 1: duration of mechanical ventilation >24 hours (DO-MV > 24 h), length of intensive care unit stay >48 hours (LOS-ICU > 48 h), and length of hospital stay >7 days (LOS-H > 7 days).
See this image and copyright information in PMC

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