The Role of Hemoglobin/Red Cell Distribution Width Value in Predicting Early Major Adverse Events after Open Heart Surgery in Elderly Patients.

Introduction: The world population is aging, and patients aged 65 and over are occupying an increasing position in cardiac surgery. As in many areas of medicine, various blood parameters have been investigated as prognostic values in cardiovascular surgery. In this current study, we aimed to investigate the place of the hemoglobin/red cell distribution width ratio (HRR) value in predicting major adverse events (MAE) that occur early after open heart surgery in elderly patients.

Methods: Patients over 65 who had open heart surgery in our clinic between January 2020 and January 2022 were included in this retrospective analysis. Patients who developed MAE during hospital follow-up were recorded as group 1, and patients who did not develop MAE were recorded as group 2.

Results: The study involved 498 patients. The median age of the 71 patients in group 1 was 73 (65-85), while the median age of the 427 patients in group 2 was 70 (65-84) (p = 0.126). Gender, body mass index, hyperlipidemia, atrial fibrillation rate, history of cerebrovascular accidents, smoking, diabetes mellitus, hypertension, and chronic obstructive pulmonary disease rates did not differ between the groups. As a result of the multivariate analysis, EuroSCORE II (OR: 3.925, 95% CI: 2.365-5.954, p < 0.001), need of intra-aortic balloon pump (OR: 1.523, 95% CI: 1.080-2.190, p = 0.029), and low HRR (OR: 0.696, 95% CI: 0.498-0.827, p < 0.002) values were found to be independent predictors of early postoperative MAE prediction.

Conclusion: In this study, we showed for the first time in the literature that the HRR value calculated from preoperative blood values is a key predictor for in-hospital MAE. In these patients, the HRR value can be used as a preoperative risk biomarker.