Relationship between hemodiastase and short-term prognosis in patients undergone open-heart surgery with cardiopulmonary bypass
Gao Hongfeng
Cheng Duan
Lei Jing
Wang Min
Yang Luming
Abstract：Objective To discuss the relationship between hemodiastase and short-term prognosis in patients undergone open-heart surgery with cardiopulmonary bypass (CPB). Methods The patients (n=121) were chosen from Xinjiang Hospital of Wuhan Asian Heart Hospital from Jan. 2017 to Jan. 2018. The level of hemodiastase was detected in all patients respectively at time of hospitalization and after the operation for 24 h, 48 h and 72 h. All patients were divided, according to whether or not postoperative hemodiastase level reached 3 times of the maximum limit of normal value, into hyperamylasemia group (≥450 U/L, n=58) and non-hyperamylasemia group (<450 U/L, n=63). The correlation among hemodiastase, procalcitonin (PCT), white blood cell count (WBC) and C-reactive protein (CRP) was analyzed. The clinical data, hours of using ventilator, ICU stay time, incidence of complication (hospital infection, hepatic insufficiency, renal insufficiency, multiple organ dysfunction syndrome, intraoperative hypotension, postoperative low cardiac output syndrome) and hospital death were recorded and compared in 2 groups. Results The difference in sex, age, surgery types, drinking history and diabetes history had no statistical significance between 2 groups (P>0.05). The levels of hemodiastase, WBC and CRP increased after the surgery, and reached peak value after 48 h then decreases gradually. The level of PCT increased and reached peak value after 24 h then decreased gradually. The comparisons in the above indexes had statistical difference at different time points (P<0.05). The results of Pearson correlation analysis showed that the level of hemodiastase was positively correlated to WBC (r=0.724, P=0.009) and CRP (r=0.685, P=0.021), and had no significant correlation to serum PCT (r=0.248, P=0.132). The incidence of hospital infection, renal insufficiency, multiple organ dysfunction syndrome, intraoperative hypotension, postoperative low cardiac output syndrome was higher, and hospital death rate were higher in hyperamylasemia group than those in non-hyperamylasemia group (P<0.05). Conclusion The occurrence of hyperamylasemia is correlated to early inflammatory reactions and has adverse influence on prognosis after open-heart surgery with CPB. The intraoperative hypotension and postoperative low cardiac output syndrome may be important factors inducing hyperamylasemia.
Keywords：HemodiastaseCardiopulmonary bypassCardiac surgeryPrognosisHyperamylasemia
Publication Date：2018-01-01
Pages：4( 1322-1324,1331 )