Estimation of cardiosurgical intervention risk according to EuroSCORE in patients with acute coronary syndrome and different gallbladder conditions before coronary artery bypass grafting

Abstract

Introduction: Estimation of cardiosurgical intervention risk according to EuroSCORE is an important aspect of cardiosurgery. EuroSCORE allows prediction of the probability of a post-operational fatal outcome. Aim: To estimate the influence of gallbladder condition on the prognosis after coronary artery bypass grafting (CABG) and and the interactions between metabolic background and cardiosurgical intervention risk. Material and methods: We investigated data of 98 patients with unstable angina pectoris or acute myocardial infarction before planned CABG. These patients were divided into the following groups according to their gallbladder condition: intact bladder; bile sludge or cholesterosis; bent gallbladder body; gallbladder neck deformations or cholecystitis; cholelithiasis; history of cholecystectomy. Results: The mean cardiosurgical intervention risk score according to the EuroSCORE system in our patients was 6.03 ±0.62%. It was significantly higher in patients with low serum bilirubin levels. There were direct correlations between the risk score result and presence of left ventricular dilatation (r = 0.31, p < 0.05) and fasting glucose level (r = 0.82, p < 0.01), as well as with means of other parameters, i.e., left atrial dimension, right ventricular size, grade of stenosis of anterior interventricular branch of left coronary artery, serum levels of total cholesterol, β-lipoproteins, bilirubin and potassium. Conclusions: These correlations suggest that the EuroSCORE results estimated before surgery may be used as a simple informative prognostic criterion of intra-operational cardiac mortality and also as a marker of structural and functional heart condition and metabolic background. However, these correlations were different in patients with different gallbladder conditions.