Cardiopulmonary bypass (CPB) provides ease of application for surgical procedures, but it
causes the body to experience some non-physiological events. With the CPB, various
mechanisms are activated by converting pulsatile blood flow to laminar flow, contact of
blood and tissues with the artificial surface of the CPB circuit, cardiac cold ischemia
and hypothermia in the body. With the endothelial activation caused by the inflammatory
response, changes occur in leukocytes, platelets, complement system activation and
coagulation cascade. As a result; intraoperative and postoperative morbidity and
mortality increase with systemic inflammatory response syndrome.
In cardiac surgery patients, due to the surgical burden combined with existing
comorbidities, evaluating the preoperative clinical status of patients and predicting
mortality rates has become an important issue of interest for clinicians. For this
purpose, mortality has been predicted with various scoring systems.
European System for Cardiac Operative Risk Evaluation-II (EUROSCORE-II) is a scoring
system that is specifically designed for patients undergoing cardiac surgery and is
widely used worldwide to predict mortality through preoperative evaluation. Recent
studies in the literature have reported that the sensitivity of EUROSCORE-II scoring may
be low in older patients (over 70 and 80 years of age). Preoperative risk assessment is
important in determining treatment plans for patients undergoing surgery, providing
patient education for the postoperative period, providing insight into prognosis, and
determining healthcare quality standards. A scoring system with higher predictive power
is targeted by making modifications to EUROSCORE-II or by making comparisons with other
scoring systems.
PreOperative Scores to Predict Post- Operative Mortality (POSPOM), defined by Le Manach
et al. in 2016, is a useful scoring system that can be used for all types of surgery and
can predict postoperative mortality with preoperative evaluation of patients. POSPOM
includes parameters that evaluate the patient's age, the type of surgery to be performed,
and the patient's comorbidities. There are various studies that have been applied to
patients with hip fracture, radical cystectomy, uro -oncological surgery, and non
-cardiac vascular surgery.
In this study, patients who apply to Istanbul University-Cerrahpasa, Institute of
Cardiology between 2020-2024 will be screened. Patients aged 18 and over, patients who
have CABG (Coronary artery bypass grafting) surgery, valve surgery or both, and patients
with on-pump surgery will be included in the study. Patients under the age of 18,
patients with off-pump surgery, and patients with non-cardiac vascular surgery will be
excluded from the study. The following will be recorded as postoperative complications;
re-sternotomy due to bleeding, re-sternotomy due to mediastinitis, new transient ischemic
attack (TIA) or cerebrovascular accident, need for hemofiltration or dialysis, use of an
intra-aortic balloon pump, wound infection, sepsis, tracheostomy.
The primary aim of the study is to evaluate the power of the POSPOM score in predicting
in-hospital mortality in patients undergoing cardiac surgery and its correlation with
EUROSCORE-II. Secondarily, it is aimed to investigate postoperative complications after
cardiac surgery.
