Can nutritional or immune markers predict development of post-operative infections in Coronary Artery Bypass Graft (CABG) patients?

Abstract

Attachedintroduction Nutritional and immune status is important in the outcome of surgical and non-surgical diseased conditions. Objectives To correlate nutritional and immune markers with development of post-operative infections in patients who had undergone CABG. Method Pre and post-operative nutritional (vitamins A and E, serum ferritin, albumin) and immune markers (Total Antioxidant Capacity (TAC), IL6) of patients (n=102) at Cardid-Thoracic Unit, SJGH were determined. Data on surgical site and other infections were collected from BHT. Results Significantly (p=0.003) high percentage of females (40%) developed infections. Patients with post-op infections (POI) had significantly high pre (p=0.02) and post-operative (p=0.01) TAC. Pre-operative cutoff of 5.9 TEAC pg/lOOg and post-operative cut-off of 6.6 TEAC pg/lOOg could predict development of POI. Significantly (p=0.006) high concentration of post-operative IL-6 was observed in patients POI. Patients who developed POI had positive correlation between pre-operative TAC and pre (r=0.45, p=0.02) and post (r=0.44, p=0.02) operative albumin. When compared with individuals without infections, the odds ratios of decreased pre-operative albumin (1.2,95% Cl 1-1.3), elevated post-operative IL-6 (1,95% Cl 0.9-1.0) and pre-operative TAC (0.6, 95% Cl 0.39-0.98) associated with POI. Conclusions Pre and post-operative TAC could predict true positive incidence of POI with moderately high specificity and true negative incidence of POI with a moderately high sensitivity respectively. Post-operative IL-6 could be a predictor for development of POI following CABG.