The role of the modified Glasgow prognostic score in predicting postoperative mortality following open-heart surgery

PURPOSE: The Modified Glasgow Prognostic Score is an inflammation-based index utilizing C-reactive protein and albumin levels. It has been investigated in various diseases such as cancer, heart failure, and myocardial infarction. Open heart surgery, particularly with cardiopulmonary bypass, induces an acute-phase inflammatory response that is associated with postoperative complications and mortality. This study aimed to evaluate the prognostic value of preoperative and early postoperative Modified Glasgow Prognostic Score in predicting early outcomes in patients undergoing open heart surgery, with the goal of improving patient stratification and surgical decision-making. METHODS: A retrospective review of medical records was conducted for 456 patients who underwent open heart surgery between January 1, 2022, and October 1, 2024. All procedures were elective cases. Patients undergoing emergency operations, including those with acute type A aortic dissection, were excluded from the study. Data were collected on demographics, laboratory results, procedure duration, ejection fraction, and presence of multi-vessel disease. All patients included in the study underwent open heart surgery with the use of cardiopulmonary bypass (CPB). Patients who underwent off-pump coronary artery bypass grafting (OPCAB) or other procedures not requiring CPB were excluded. Both preoperative and postoperative Modified Glasgow Prognostic Score were analyzed to assess their association with early postoperative outcomes. RESULTS: Preoperative mGPS was found to be significantly associated with early mortality (p < 0.05). A one-unit increase in Modified Glasgow Prognostic Score was associated with a 2.85-fold increase in mortality risk (95% CI: 1.85–4.41). However, no significant relationship was observed between postoperative Modified Glasgow Prognostic Score and mortality (p > 0.05). CONCLUSIONS: Preoperative Modified Glasgow Prognostic Score serves as a valuable prognostic marker for early mortality in open heart surgery patients. It provides independent predictive value and can enhance preoperative risk assessment, ultimately improving patient outcomes and guiding surgical management.