Relationship between Fibrinogen Values and Sensitivity and Specificity of STS Score, Euroscore for Patients Undergoing Open Heart Surgery

Background/Aim: Cardiovascular diseases are a leading cause of mortality worldwide, with surgical interventions playing a crucial role in outcomes. Despite technological advancements and improved operator experience, perioperative and postoperative risks remain significant, particularly for high-risk patients. Fibrinogen, an acute-phase reactant, increases during inflammation and plays a role in coagulation. This study investigates the prognostic impact of fibrinogen levels on the outcomes of cardiac surgery and evaluates its relationship with established risk classification systems. Materials and Methods: This observational cohort study included 105 patients who underwent cardiac surgery between May 2018 and December 2023. Patients with coronary bypass grafting and valve surgery were included, while those with transplantation, congenital heart surgery, or other significant conditions were excluded. Patient data, including demographic information, comorbidities, laboratory parameters, and surgical details, were collected. The fibrinogen cutoff value was determined using the Youden index. Statistical analyses were performed using SPSS 23.0, with p-values < 0.05 considered significant. Results: Of the 116 individuals screened, 105 were included in the study. The HighFib group (>3.8 g/dL) showed higher rates of complications, such as low cardiac output, prolonged mechanical ventilation, and atrial fibrillation, compared to the LowFib group (<3.8 g/dL). The HighFib group also had lower preoperative hemoglobin levels and higher Euroscore values. Logistic regression analysis demonstrated that both fibrinogen levels and established risk scores were significant predictors of postoperative complications. Conclusion: Elevated fibrinogen levels are associated with increased postoperative complications in cardiac surgery patients. Fibrinogen, alongside traditional risk scores, can be a valuable predictor of adverse outcomes. Prospective studies are needed to further validate these findings and establish optimal fibrinogen management strategies in cardiac surgery.