Sequential Organ Failure Assessment score and procalcitonin serum concentrations in patients with systolic heart failure early after cardiac surgery

Introduction

Previously we investigated the clinical course of patients with good left ventricle ejection fraction (EF) by assessing the Sequential Organ Failure Assessment (SOFA) score and procalcitonin (PCT) level early after cardiac surgery. In this study we included patients with systolic heart failure (HF), prospectively collecting data: B-type natriuretic peptide (BNP), PCT, and SOFA score.

Methods

Two hundred and seventy-five patients (subjected to coronary artery bypass grafting, valve reconstruction or combined operations) were divided into three groups: echocardiographically estimated EF > 30% for the PCT group (group A, n = 102), the control group (group B, n = 103), and patients with EF < 30% for BNP analysis (group C, n = 70). PCT was measured pre-operatively, 6 hours, 24 hours and 48 hours postoperatively. The SOFA score was assessed daily as SOFA1, SOFA2, SOFA3. BNP was measured preoperatively in patients with HF.

Results

PCT serum concentrations are presented in Table 1. In groups A, B, and C, SOFA1 was 1.31 ± 1.67 vs 1.62 ± 1.65 (P > 0.05), and 4.73 ± 2.57 (P < 0.05). SOFA2 was 0.97 ± 1.56 vs 1.34 ± 1.67 (P > 0.05), vs 4.69 ± 2.47 (P < 0.05). SOFA3 was 0.63 ± 1.11 vs 1.13 ± 1.68 (P = 0.0178), and 4.04 ± 1.81, respectively. The ICU stay was 5.74 ± 11.49 days in group A, 6.97 ± 11.61 days (P = 0.04476) in group B, and 3.5 ± 1.11 days in group C. The postoperative hospital stay was 12.08 ± 11.28 days vs 12.93 ± 10.73 days vs 12.25 ± 2.5 days (P > 0.05) in group A vs group B vs group C. Inhospital mortality was 3% vs 3% vs 2.8% (P = 0.8038) in the three groups.

Table 1 (abstract P467)

Discussion

We have found that the SOFA3 score had a predicting value in the mortality rate as well as PCT concentrations measured 48 hours after surgical intervention.