Postoperative Adenosine Deaminase Activity Predicts Complications After On-Pump Cardiac Surgery

Various factors associated with cardiopulmonary bypass (CPB) can produce an inflammatory response, resulting in morbidity and mortality. The aim of this study was to investigate how adenosine deaminase (ADA) activity changes after surgery in relation to the emergence of CPB-related complications.

The study included 78 patients, of whom 30 had complications. Blood samples were collected three times: on admission to the ward (preoperative), on the first postoperative day, and on the fifth postoperative day. The blood samples were analyzed for routine hematological and biochemical variables. In addition, serum ADA activity was evaluated, and normalized ADA [ADA_(Nor)] levels were calculated.

On postoperative day 1, ADA and ADA_(Nor) levels differed between the groups. In multivariate analysis, left atrium diameter (p = 0.015), and ADA_(Nor) (p = 0.001) on postoperative day 1 were significant predictors of CPB-related complications. Receiver operating characteristic curve analysis showed that the area under curve for postoperative first day ADA_(Nor) was 0.767 (95% confidence interval 0.664-0.871). Using a cut-off value of 11.87, postoperative first day ADA_(Nor) predicted postoperative complication emergencies with 63.3% sensitivity and 77.1% specificity.

This study is the first to identify blood ADA_(Nor) activity as an independent risk factor for the development of postoperative CPB-related complications.