[Prognostic scale for early detection of various postoperative complications after thoracic aortic surgery: post-hoc analysis of biomarkers].

OBJECTIVE

To create the prognostic scale based on some biomarkers after thoracic and thoracoabdominal aortic repair.

MATERIAL AND

METHODS

We analyzed 114 patients with aortic aneurysm/dissection. The following biomarkers were studied: proadrenomedullin, NT-proBNP, procalcitonin, interleukins 6, 8, 10, tumor necrosis factor, presepsin, highly sensitive troponin I. Stages of the study: before induction of anesthesia, at the end of surgery and 6 hours later.

RESULTS

The most informative predictors of postoperative complications were identified using comparative and ROC analyses: baseline presepsin≥204 pg/ml and interleukin 6 ≥4.3 pg/ml. The scale based on assessment of presepsin and troponin I at the end of surgery and preoperative risk allows analysis of the risk of complicated postoperative period. If all three predictors are present, the risk of complicated postoperative period increases by 1.96 times. The equation based on serum presepsin, interleukin-8 and interleukin-6/interleukin-10 ratio in 6 hours after surgery is characterized by acceptable characteristics (AUC 0.785, 95% CI 0.700-0.870).

CONCLUSION

An algorithm based on risk stratification consisting of 3 prognostic scales at various stages of perioperative period determines the probability of postoperative complications with sensitivity 67.2% and specificity 94.6%. The total share of correct predictions in this sample was 80.7±3.7%.