Plasma Calcium Level and C-Reactive Protein Albumin Ratio Affect Severe Bleeding After Coronary Artery Bypass...

Area of Science:

• Cardiology
• Biochemistry
• Surgical Outcomes

Background:

• Coronary artery bypass grafting (CABG) is a major surgical procedure.
• Predicting and preventing severe bleeding post-CABG is crucial for patient outcomes.
• Identifying reliable biomarkers for bleeding risk is an ongoing area of research.

Purpose of the Study:

• To investigate the predictive value of plasma calcium levels and C-reactive protein albumin ratio (CAR) for severe bleeding after CABG.
• To evaluate other demographic and hematological markers in relation to severe bleeding post-CABG.

Main Methods:

• Prospective study of 227 adult patients undergoing CABG.
• Measurement of chest tube drainage within 24 hours postoperatively.
• Comparison of demographic, clinical, and preoperative blood parameters between low bleeding and severe bleeding groups.
• Univariate and multivariate regression analyses to identify independent predictors of severe bleeding.

Main Results:

• Patients with severe bleeding (n=53) had significantly higher cardiopulmonary bypass time and serum C-reactive protein (CRP) levels compared to the low bleeding group (n=174).
• Significantly lower levels of lymphocytes, hemoglobin, calcium, albumin, and CAR were observed in the severe bleeding group.
• Multivariate analysis identified calcium, albumin, CRP, and CAR as independent predictors of excessive bleeding, with specific cut-off values for calcium (8.7) and CAR (0.155) demonstrating high sensitivity and specificity.

Conclusions:

• Plasma calcium level, serum C-reactive protein (CRP), albumin, and C-reactive protein albumin ratio (CAR) are valuable predictors of severe bleeding following CABG.
• These markers can aid in the early identification of patients at high risk for excessive bleeding, potentially guiding clinical management.