The Value of Serum Amyloid A on Early Diagnosing and Prognosis for Perioperative Patients with Extracorporeal Circulation

Abstract

The present study was aimed to investigate the value of serum amyloid A in the early diagnosis of infection in patients with extracorporeal circulation and to evaluate the prognosis of patients. This was a prospective observational study. Patients admitted to the intensive care unit after cardiopulmonary bypass surgery between January 2017 and January 2019 were continuously collected. Daily blood serum amyloid A and traditional inflammatory markers (white blood cell, C-reactive protein and procalcitonin) were continuously monitored 1 day before surgery and 3 days after surgery. The efficacy of serum amyloid A and traditional inflammatory indicators in the early diagnosis of infection was assessed by receiving operating characteristic curve, and the efficacy of serum amyloid A in predicting the prognosis of patients was assessed by multivariate logistic regression analysis. A total of 150 patients admitted to ICU after extracorporeal circulation was included in the study period. There were 58 patients with perioperative infection and 92 patients in the non-infected group. There were 18 patients in the death group, accounting for 12 %. Serum amyloid A and traditional inflammatory indicators were increased in all patients on the first day after surgery compared with that before surgery, but in the non-infected group and the survival group, the decrease rate was significantly faster than that in the infected group and the death group within three days after surgery, p<0.05. According to ROC curve analysis, the diagnostic efficacy of perioperative infection was serum amyloid A, C-reactive protein, procalcitonin and white blood cell respectively, and the sensitivity and specificity were 84.48 and 86.96, 79.31 and 89.13, 65.52 and 98.91, 89.66, and 71.74 %, respectively. Multivariate logistic regression analysis indicated that the blood serum amyloid A level on the first day after surgery was an independent risk factor for hospitalization and death, OR was 1.49 (95 % CI was 1.27-2.96, p<0.01). Serum amyloid A could be used for early diagnosis of perioperative infection after extracorporeal circulation, and is an independent risk factor for prognosis of patients, and its value is better than traditional inflammatory indicators.