ORIGINAL ARTICLE   

Minerva Anestesiologica 2022 October;88(10):771-9

DOI: 10.23736/S0375-9393.22.16297-8

Copyright © 2022 EDIZIONI MINERVA MEDICA

lingua: Inglese

Increased preoperative serum vitamin B12 level as a predictor of postoperative mortality in patients undergoing cardiac surgery

Seohee LEE ¹, Karam NAM ¹ ✉, Sun-Young JUNG ², Dongnyeok PARK ¹, Jae-Woo JU ¹, Jinyoung BAE ¹, Youn-Joung CHO ¹, Yunseok JEON ¹

¹ Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea; ² College of Pharmacy, Chung-Ang University, Seoul, South Korea

BACKGROUND: Serum vitamin B12 level is a useful prognostic marker for various conditions. The present study examined whether preoperative serum vitamin B12 level can predict mortality after cardiac surgery.
METHODS: The present observational study comprised adult patients who underwent cardiac surgery at our institute between 2012 and 2019. The performance of preoperative vitamin B12 level in discriminating postoperative in-hospital mortality, the primary outcome of this study, was assessed by receiver operating characteristic (ROC) curve analysis. After dichotomizing vitamin B12 level using Youden’s J Index, weighted logistic regression analysis was performed. Cumulative all-cause mortality, the secondary outcome, was also compared using the Kaplan-Meier estimator and Cox regression analysis.
RESULTS: A total of 973 patients were analyzed. The area under the ROC curve of vitamin B12 level for predicting in-hospital mortality was 0.76 (95% confidence interval [CI]: 0.73-0.78). Weighted logistic regression analysis revealed that the high vitamin B12 group (>726 pg/mL) had a significantly increased risk of in-hospital mortality compared to the low vitamin B12 group (adjusted odds ratio, 12.01; 95% CI: 7.73-18.67). The risk of mortality was higher in the high vitamin B12 group than the low vitamin B12 group (log-rank test, P<0.001; adjusted hazard ratio, 2.41; 95% CI: 1.70-2.39). In addition, the high vitamin B12 group had significantly poorer survival than the low vitamin B12 group, even within the same EuroSCORE II stratum (< or ≥4%; log-rank test, P<0.001 and P=0.001, respectively).
CONCLUSIONS: Preoperative measurement of serum vitamin B12 level may be an alternative for predicting the prognosis of patients undergoing cardiac surgery.

KEY WORDS: Cardiac surgical procedures; Vitamin B 12; Mortality