The correlation between preoperative erythrocyte sedimentation rate and postoperative outcome in adult cardiac surgery

Figures & data

Table 1 The presentation of the frequency (percentage) of four preoperative ESR groups

ESR group	n (%)
ESR not measured	58 (9.4)
ESR measured*
Normal value	397 (64)
Moderately increased	116 (18.7)
Severely increased	49 (7.9)
Total	620 (100)

Notes:

* Normal value: ESR value <15 mm/h or <20 mm/h in female or male patients, respectively; moderately increased: ESR value <40 mm/h; severely increased: ESR value ≥40 mm/h.

Abbreviation: ESR, erythrocyte sedimentation rate.

Table 2 Pre and postoperative characteristics of the four preoperative ESR groups

Characteristic	Preoperative ESR*
	Normal value (n=397)	Moderately increased (n=116)	Severely increased (n=49)	Not measured (n=58)	Total (n=620)	P-value
Male/female	260/137	73/43	32/17	37/21	402/218	0.96
Age (years; mean±SD)	57.46±13.53	57.41±12.86	55.29±12.27	60.21±9.53	57.54±13.00	0.27
Weight (kg; mean±SD)	71.55± 12.53	72.35±13.59	71.44±12.46	73.39±12.48	71.86±12.71	0.72
Height (cm; mean±SD)	164.94±7.89	163.85±8.04	164.17±8.56	165.31±8.36	164.71±8.02	0.53
Diabetes mellitus, n (%)	64 (17.4)	21 (18.1)	8 (16.3)	9 (15.5)	102 (16.5)	0.96
Cigarette smoking, n (%)	140 (35.3)	46 (39.6)	19 (38.8)	15 (25.9)	220 (35.5)	0.33
Preoperative angina pectoris, n (%)	282 (71.0)	89 (76.7)	40 (81.6)	47 (81.0)	458 (73.9)	0.16
Recent preoperative myocardial infarction, n (%)	109 (27.4)	23 (19.8)	6 (12.2)	13 (22.4)	151 (24.4)	0.06
Left ventricle ejection fraction	46.2±9.3	46.1± 8.5	46.7± 9.6	47.2± 8.0	46.3± 9.1	0.862
Sublingual temperature (mean±SD)	36.7±0.36	36.7±0.33	36.5±0.40	36.6±0.33	36.7±0.35	0.103
Hematocrit% (mean±SD)	42.3±5.4	39.1±4.9	35.9±5.5	39.8±4.8	40.9±5.6	0.001
Platelet × 10^3/mm^3 (mean±SD)	209±62	229±58	248±84	223±77	217±66	0.001
White blood cell × 10^3/mm^3 (mean±SD)	7.4±2.3	7.6±2.1	8.7±4.0	9.0±3.6	7.7±2.6	0.001
Serum creatinine, mg/dL (mean±SD)	0.96±0.47	1.07±0.72	1.42±1.48	1.34±1.67	1.05±0.83	0.001
C-Reactive protein, mg/L (mean±SD)	42.57±102.69	25.42±82.76	23.32±78.94	11.41±51.22	35.23±94.44	0.133
Type of surgery
CABG, n (%)	300 (75.6)	94 (81.0)	40 (81.6)	47 (81.0)	481 (77.6)	0.929
Valvular, n (%)	38 (9.6)	5 (4.3)	4 (8.2)	8 (13.8)	55 (8.9)
CABG/valvular, n (%)	29 (7.3)	6 (5.2)	2 (4.1)	2 (3.4)	39 (6.3)
Others, n (%)	30 (7.5)	11 (9.5)	3 (6.1)	1 (1.8)	45 (7.2)
Using CPB, n (%)	281 (70.8)	73 (62.9)	35 (71.4)	34 (58.6)	423 (68.2)	0.418
Ventilatory support (hours)	19.6±1.2	18.2±2.1	25.3±4.7	21.0±3.7	19.9±2.9	0.399
ICU stay (days)	4.2±0.2	4.2±0.3	6.4±0.9	4.8±0,6	4.4±0.5	0.003
Hospital stay (days)	7.9±0.3	8.0±0.6	10.5±1.0	8.7±0.07	8.2±0.7	0.023

Notes:

* Normal value: ESR value <15 mm/h or <20 mm/h in female or male patients, respectively; moderately increased: ESR value <40 mm/h; severely increased: ESR value ≥40 mm/h.

Abbreviations: ESR, erythrocyte sedimentation rate; CABG, coronary arteries bypass graft surgery; CPB, cardiopulmonary bypass; ICU, intensive care unit.

Table 3 Postoperative complication and mortality rate due to preoperative ESR

Complication	Preoperative ESR*
	Normal value (n=397)	Moderately increased (n=116)	Severely increased (n=49)	Not measured (n=58)	Total (N=620)	P-value
Cardiac, n (%)	152 (38.2)	35 (30.1)	15 (30.6)	24 (41.4)	226 (36.5)	0.275
Respiratory, n (%)	41 (10.3)	13 (11.2)	4 (8.1)	7 (12.1)	65 (10.4)	0.916
Renal, n (%)	28 (7)	4 (3.4)	3 (6.1)	3 (5.2)	38 (6.1)	0.546
Infectious, n (%)	17 (4.2)	6 (5.2)	2 (4.1)	2 (3.4)	27 (4.4)	0.957
Unclosed sternum/bleeding control surgery, n (%)	21 (5.2)	7 (6)	3 (6.1)	3 (5.2)	34 (5.5)	0.986
Neurologic, n (%)	24 (6)	8 (6.8)	0 (0)	3 (5.2)	35 (5.6)	0.332
Miscellaneous, n (%)	18 (4.5)	4 (3.4)	5 (10)	6 (10.3)	33 (5.3)	0.089
Long ICU or hospital stay period, n (%)	101 (25.4)	26 (22.4)	26 (53.1)**	19 (32.8)	172 (27.7)	0.018
Overall complication rate, n (%)	219 (55.2)	59 (50.9)	32 (65.3)	35 (60.3)	345 (55.6)	0.323
Mortality, n (%)	35 (8.8)	5 (4.3)	2 (4.1)	3 (5.17)	45 (7.3)	0.257

Notes:

* Normal value: ESR value <15 mm/h or <20 mm/h in female or male patients, respectively; moderately increased: ESR value <40 mm/h; severely increased: ESR value ≥40 mm/h.

** The rate of the long ICU or hospital stay was higher in severely increased ESR group than normal value or moderately increased groups (P-value, 0.001).

Abbreviations: ESR, erythrocyte sedimentation rate; ICU, intensive care unit.

Table 4 The relationship between postoperative morbidity and mortality rate with various CRP levels

Complication	CRP groups
	Normal P-value (0–5 mg/L), n=372	Mildly increased (5–40 mg/L), n=17	Moderately increased (40–200 mg/L), n=14	Severely increased (>200 mg/L), n=39	P-value
Cardiac, n (%)	128 (34.4)	8 (47.1)	6 (42.9)	18 (46.2)	>0.05
Respiratory, n (%)	35 (9.4)	2 (11.8)	1 (7.1)	8 (20.5)	<0.05*
Renal, n (%)	17 (4.5)	1 (5.9)	2 (14.3)	5 (12.8)	<0.05*
Infectious, n (%)	13 (3.4)	0 (0)	1 (7.1)	8 (20.5)	<0.05*
Bleeding or unclosed sternum, n (%)	14 (3.8)	1 (5.9)	1 (7.1)	5 (12.8)	<0.05*
Neurologic, n (%)	22 (5.9)	1 (5.9)	1 (7.1)	2 (5.1)	>0.05
Miscellaneous, n (%)	18 (4.8)	1 (5.9)	1 (7.1)	2 (5.1)	>0.05
Complications (all types), n (%)	137 (36.8)	9 (52.9)	5 (35.7)	22 (56.4)	<0.05*
Mortality, n (%)	15 (4%)	1 (5.9)	1 (7.1)	6 (15.4)	<0.05*
Ventilatory support (hours)	20.2±1.3	20.6±5.5	20.1±7.9	24.3±5.9	<0.05*
ICU stay (days)	4.5±0.2	4.2±0.7	5.0±1.4	5.7±3.5	<0.05*
Hospital stay (days)	8.4±0.3	7.5±1.1	6.6±0.8	9.1±3.1	<0.05*

Notes:

* Significant differences between severely increased CRP group with other groups. ESR was not different in various preoperative CRP levels.

Abbreviations: CRP, C-reactive protein; ICU, intensive care unit; ESR, erythrocyte sedimentation rate.