Objective To investigate risk factors for hypoalbuminemia after coronary artery bypass grafting(CABG)and its association with clinical outcome.Methods A total of 483 patients undergoing CABG were retrospectively analyzed.The diffe-rence in serum albumin(ALB)level between the first day after operation and before operation was defined as △ ALB.The patients were divided by △ALB in group A(△ALB ≤7 g/L,97 cases),group B(7 g/L＜△ALB ≤15 g/L,298 cases),and group C(△ALB＞15 g/L,88 cases).The three groups were compared in terms of preoperative,intraoperative,and postoperative data and the incidence of major adverse cardiovascular events(MACE)36 months after surgery.Results The percentages of patients with hyperuricemia and patients with left ventricular ejection fraction(LVEF)＜40％were significantly higher in group C than in group A and group B(X2=6.802-6.857,P＜0.05).The percentage of patients with a history of percutaneous coronary interven-tion(PCI)was significantly higher in groups B and C than in group A(x2=8.193,P＜0.05).Group C showed significantly higher proportions of patients with intensive care unit stay more than 72 h,drainage volume more than 400 mL on the day of CABG,mas-sive blood loss,red blood cell transfusion,plasma transfusion,and renal injury compared with groups A and B(x2=6.741-39.287,P＜0.05).The incidence of MACE in group C was significantly higher than that in groups A and B(x2=8.205,P＜0.05).According to the Cox regression analysis adjusting for confounding factors,a PCI history(OR=1.670,95％CI=1.091-2.556,P=0.018)and LVEF＜40％(OR=4.468,95％CI=2.304-8.665,P＜0.001)before surgery were independent risk factors for a decreased serum ALB level after surgery;7 g/L＜△ALB ≤15 g/L(OR=2.784,95％CI=1.190-6.516,P=0.018)and it＞15 g/L(OR=3.487,95％CI=1.373-8.853,P=0.009)were independent predictors of the occurrence of long-term MACE.Conclusion A PCI history and LVEF＜40％are independent risk factors for hypoalbuminemia after CABG.An ALB decrease by＞7 g/L on the first day after operation is a predictor of the outcome of CABG.
维普
万方数据