Next Article in Journal
The Knowledge, Attitudes, and Practices of Community Pharmacists in their Approach to Antibiotic Use: A Nationwide Survey in Italy
Next Article in Special Issue
Sepsis and Nosocomial Infections: The Role of Medico-Legal Experts in Italy
Previous Article in Journal
Exacerbations of Chronic Rhinosinusitis—Microbiology and Perspectives of Phage Therapy
Previous Article in Special Issue
Predictors of Appropriate Antibiotic Use in Bacteremia Patients Presenting at the Emergency Department
Article

The Preoperative Inflammatory Status Affects the Clinical Outcome in Cardiac Surgery

1
Department of Emergency and Organ Transplantations, Section of Cardiac Surgery, Consorziale Policlinico University Hospital, Bari-University of Bari, 70124 Bari, Italy
2
Department of Cardiac Surgery, “Circolo” Hospital, Insubria University, 21100 Varese, Italy
3
Department of Emergency/Urgency, Poisoning National Centre, “Riuniti” University Hospital, 71100 Foggia, Italy
*
Author to whom correspondence should be addressed.
These Authors have contributed equally to the work.
Received: 21 May 2019 / Revised: 26 September 2019 / Accepted: 28 September 2019 / Published: 5 October 2019
(This article belongs to the Special Issue Sepsis: Pathophysiology, Diagnosis and Therapy)
Aims: There are many reasons for the increase in post-operative mortality and morbidity in patients undergoing surgery. In fact, an activated inflammatory state before cardiac surgery, can potentially worsen the patient’s prognosis and the effects of this preoperative inflammatory state in the medium-term remains unknown. Methods: There were 470 consecutive patients who underwent cardiac surgery, and were divided in three groups according to the median values of preoperative C-reactive protein (CRP) and fibrinogen (FBG): The first group was the low inflammatory status group (LIS) with 161 patients (CRP < 0.39 mg/dL and FBG < 366 mg/dL); the second was the medium inflammatory status group (MIS) with 150 patients (CRP < 0.39 mg/dL and FBG ≥ 366 mg/dL or CRP ≥ 0.39 mg/dL and FBG < 366 mg/dL,); and the third was the high inflammatory status group (HIS) with 159 patients (CRP ≥ 0.39 mg/dL and FBG ≥ 366 mg/dL,). Results: The parameters to be considered for the patients before surgery were similar between the three groups except, however, for age, left ventricular ejection fraction (LVEF) and the presence of arterial hypertension. The operative mortality was not significantly different between the groups (LIS = 2.5%, MIS = 6%, HIS = 6.9%, p = 0.16) while mortality for sepsis was significantly different (LIS = 0%, MIS = 1.3%, HIS = 3.7%, p = 0.03). The infections were more frequent in the HIS group (p = 0.0002). The HIS group resulted in an independent risk factor for infections (relative risk (RR) = 3.1, confidence interval (CI) = 1.2–7.9, p = 0.02). During the 48-months follow-up, survival was lower for the HIS patients. This HIS group (RR = 2.39, CI = 1.03–5.53, p = 0.05) and LVEF (RR = 0.96, CI = 0.92–0.99, p = 0.04) resulted in independent risk factors for mortality during the follow-up. Conclusions: The patients undergoing cardiac surgery with a preoperative highly activated inflammatory status are at a higher risk of post-operative infections. Furthermore, during the intermediate follow-up, the preoperative highly activated inflammatory status and LVEF resulted in independent risk factors for mortality. View Full-Text
Keywords: Inflammation; Inflammatory Status; C-Reactive Protein (CRP); Fibrinogen (FBG); Cardiac Surgery; Outcome; Clinical management; Infection risk; Sepsis; Cardio-Pulmonary Bypass (CBP) Inflammation; Inflammatory Status; C-Reactive Protein (CRP); Fibrinogen (FBG); Cardiac Surgery; Outcome; Clinical management; Infection risk; Sepsis; Cardio-Pulmonary Bypass (CBP)
Show Figures

Figure 1

MDPI and ACS Style

D’Agostino, D.; Cappabianca, G.; Rotunno, C.; Castellaneta, F.; Quagliara, T.; Carrozzo, A.; Mastro, F.; Charitos, I.A.; Beghi, C.; Paparella, D. The Preoperative Inflammatory Status Affects the Clinical Outcome in Cardiac Surgery. Antibiotics 2019, 8, 176. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics8040176

AMA Style

D’Agostino D, Cappabianca G, Rotunno C, Castellaneta F, Quagliara T, Carrozzo A, Mastro F, Charitos IA, Beghi C, Paparella D. The Preoperative Inflammatory Status Affects the Clinical Outcome in Cardiac Surgery. Antibiotics. 2019; 8(4):176. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics8040176

Chicago/Turabian Style

D’Agostino, Donato, Giangiuseppe Cappabianca, Crescenzia Rotunno, Francesca Castellaneta, Teresa Quagliara, Alessandro Carrozzo, Florinda Mastro, Ioannis A. Charitos, Cesare Beghi, and Domenico Paparella. 2019. "The Preoperative Inflammatory Status Affects the Clinical Outcome in Cardiac Surgery" Antibiotics 8, no. 4: 176. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics8040176

Find Other Styles
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Access Map by Country/Region

1
Back to TopTop