The impact of the Naples prognostic score on outcomes in patients undergoing coronary artery bypass grafting.

Abstract

Background: This study aimed to evaluate the prognostic value of the Naples prognostic score (NPS) in patients undergoing isolated coronary artery bypass grafting (CABG).

Methods: Patients undergoing isolated CABG were retrospectively analyzed. Patients were stratified into three groups based on preoperative NPS values. Thirty-day and one-year mortality, postoperative atrial fibrillation (AF), intensive care unit (ICU) and ward length of stay were recorded. Logistic regression analysis was used to assess the independent predictive value of NPS. Its contribution to the European System for Cardiac Operative Risk Evaluation II (EuroSCORE II) model was evaluated using ROC curves and Nagelkerke R².

Results: A total of 1.195 patients were included. Higher NPS was significantly associated with 30-day (odds ratio [OR] =1.838) and 1-year mortality (OR=1.620) (p<0.001). Postoperative AF was significantly more common in higher NPS groups (p=0.010). NPS was significantly associated with both ICU length of stay (p<0.001) and ward length of stay (p=0.029). The addition of NPS to EuroSCORE improved the predictive performance for both 30-day and 1-year mortality. Patients with higher NPS had significantly lower survival during follow-up.

Conclusion: The NPS is an independent and significant predictor of short- and long-term mortality in patients undergoing isolated CABG. As a simple, objective score reflecting both inflammatory and nutritional status, NPS enhances the predictive capacity of established risk models when integrated preoperatively.