The relationship between Systemic İmmuneinflammatory Index and C-reactive protein/albumin ratio and postoperative prognosis in patients undergoing isolated coronary artery bypass graftingat our hospital

Objective: Inflammation is known to play a central role in the development of atherosclerotic cardiovascular diseases. Chronic inflammatory processes have a direct impact on plaque formation, progression, and complications from the very onset of atherosclerosis. This study aimed to investigate the potential prognostic value of the systemic immune- inflammation index (SII) and the C-reactive protein/Albumin (CRP/Alb) ratio in predicting postoperative complications and mortality in patients undergoing coronary artery bypass grafting (CABG). Materials and Methods: The study was conducted on 200 patients who underwent isolated CABG at the Department of Cardiovascular Surgery, Afyonkarahisar University of Health Sciences, between January 2019 and December 2023. After applying exclusion criteria, 179 patients were included in the analysis. Demographic data, laboratory parameters, and postoperative outcomes were retrospectively obtained from the hospital information management system and patient records. SII and CRP/Alb ratios were calculated in the preoperative period, and their associations with postoperative complications and mortality were statistically analyzed. Results: According to the findings, a statistically significant difference was observed between the development of atrial fibrillation (AF) and the CRP/Alb ratio (p = 0.043). This difference was explained by the fact that patients who did not develop AF had significantly higher CRP/Alb ratios compared to those who did. Moreover, a low-level positive and significant correlation was found between the CRP/Alb ratio and the length of stay in the Intensive Care Unit (ICU) (Spearman R = 0.186; p = 0.013). This suggests that as the CRP/Alb ratio increases, the duration of ICU stay may also be prolonged. The mean value of SII was calculated as 803.09, with a median of 585.39; the minimum value was 53.76, and the maximum value was 9827.95. The mean CRP/Alb ratio was 1.46, with a median of 0.58; the minimum value was 0.01, and the maximum value was 19.29. Conclusion: This study demonstrated that the SII and the CRP/Alb ratio are associated with postoperative prognosis in patients undergoing isolated coronary artery bypass grafting (CABG). The findings revealed a significant relationship between the CRP/Alb ratio and the development of atrial fibrillation, as well as a positive correlation with the length of stay in the intensive care unit. These results suggest that SII and, in particular, the CRP/Alb ratio may serve as potential prognostic markers for predicting postoperative complications and guiding patient management after CABG surgery. Keywords: CRP/Alb ratio, Coronary artery bypass grafting, Coronary artery disease, Systemic immune-inflammation index.