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Background: To evaluate the association between inflammation and nutrition-based biomarkers and postoperative outcomes after non-cardiac surgery.
Methods: Between January 2011 and June 2019, a total of 102,052 patients undergoing non-cardiac surgery were evaluated, with C-reactive protein (CRP), albumin, and complete blood count (CBC) measured within six months before surgery. We assessed their CRP-to-albumin ratio (CAR), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and modified Glasgow Prognostic Score (mGPS). We determined the best cut-off values by using the receiver operating characteristic (ROC) curves. Patients were divided into high and low groups according to the estimated threshold, and we compared the one-year mortality.
Results: The one-year mortality of the entire sample was 4.2%. ROC analysis revealed areas under the curve of 0.796, 0.743, 0.670, and 0.708 for CAR, NLR, PLR, and mGPS, respectively. According to the estimated threshold, high CAR, NLR, PLR, and mGPS were associated with increased one-year mortality (1.7% vs. 11.7%, hazard ratio [HR]: 2.38, 95% CI [2.05, 2.76], P < 0.001 for CAR; 2.2% vs. 10.3%, HR: 1.81, 95% CI [1.62, 2.03], P < 0.001 for NLR; 2.6% vs. 10.5%, HR: 1.86, 95% CI [1.73, 2.01], P < 0.001 for PLR; and 2.3% vs. 16.3%, HR: 2.37, 95% CI [2.07, 2.72], P < 0.001 for mGPS).
Conclusions: Preoperative CAR, NRL, PLR, and mGPS were associated with postoperative mortality. Our findings may be helpful in predicting mortality after non-cardiac surgery.
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http://dx.doi.org/10.4097/kja.23068 | DOI Listing |
Front Med (Lausanne)
August 2025
Department of Anesthesiology, Zhuhai City People's Hospital, The Affiliated Hospital of Beijing Institute of Technology, Zhuhai Clinical Medical College of Jinan University, Zhuhai, Guangdong, China.
Background: Postoperative deep venous thrombosis (DVT) is a critical complication of non-cardiac surgery. Hypoalbuminemia reflects both nutritional depletion and inflammation, which may contribute to DVT pathogenesis. In this study, we evaluated preoperative albumin's association with DVT in patients undergoing elective non-cardiac surgery, and identified risk-stratifying thresholds.
View Article and Find Full Text PDFSurg Case Rep
August 2025
Department of Cardiac and Vascular Surgery, Dokkyo Medical University School of Medicine, Shimotsugagun, Tochigi, Japan.
Introduction: Prosthetic valve endocarditis following aortic root replacement (ARR) typically necessitates redo-ARR, which involves complete graft removal, extensive aortic root dissection, and coronary reimplantation. This highly invasive procedure carries substantial surgical risk, including high operative mortality. In select high-risk patients without evidence of prosthetic graft infection, alternative surgical strategies may reduce procedural complexity and improve outcomes.
View Article and Find Full Text PDFJ Am Geriatr Soc
September 2025
Frailty Research Center, Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts, USA.
Background: Prehabilitation may help older adults recover after surgery, yet adherence has been variable. We assessed the feasibility of a multi-component prehabilitation program.
Methods: This single-arm trial was conducted at an academic medical center to test the feasibility of an individualized prehabilitation program before major surgery.
J Obes Metab Syndr
September 2025
Integrated Perioperative Geriatric Excellent Research Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Background: Morbid obesity is a well-established risk factor for cardiovascular disease. Diastolic dysfunction, particularly in non-cardiac surgeries, has been associated with increased incidence of adverse cardiovascular events. This study aimed to evaluate the prevalence of diastolic dysfunction in morbidly obese patients undergoing bariatric surgery and to identify associated clinical risk factors using transesophageal echocardiography (TEE).
View Article and Find Full Text PDFJ Clin Anesth
September 2025
Department of Anaesthesiology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105AZ Amsterdam, the Netherlands; Department of Intensive Care, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105AZ Amsterdam, the Netherlands; Department of Epidemiology and Data Science, Amsterdam UM
Background: Many physiological processes show a diurnal rhythm, including sympathetic and parasympathetic tone, adrenal hormone secretion and blood pressure. Since these physiological rhythms may affect the sensitivity to anaesthesia, we hypothesised that the time of day when anaesthesia induction occurs may affect the incidence of post-induction hypotension.
Methods: This was a post-hoc propensity score matched analysis of prospectively collected blood pressure data of 760 elective non-cardiac surgery patients receiving general anaesthesia.