Coronary artery bypass grafting is a commonly performed heart surgery, but patients may have different risks for postoperative complications even when their preoperative risk scores are similar. EuroSCORE II is widely used to estimate surgical risk before cardiac surgery, but it may not fully reflect how the body responds during the early postoperative period.
This retrospective observational study will evaluate adult patients who underwent elective coronary artery bypass grafting with cardiopulmonary bypass between January 1, 2022 and December 31, 2025. The study will use existing hospital records and laboratory data. No additional treatment, test, or intervention will be given to patients as part of this study.
The main aim is to examine whether early postoperative changes in inflammatory and renal laboratory markers can identify different patient subgroups, called phenotypes. These markers include neutrophil-to-lymphocyte ratio, systemic immune-inflammation index, triglyceride-glucose index, and serum creatinine. The study will evaluate whether these phenotype groups are associated with postoperative acute kidney injury and prolonged intensive care unit stay.
The study will also assess whether this early postoperative phenotype-based classification provides additional risk information beyond EuroSCORE II.
Adult patients aged 18 years or older
Patients who underwent elective on-pump coronary artery bypass grafting
Patients operated between January 1, 2022 and December 31, 2025
Patients with available perioperative clinical and laboratory data required for analysis
Patients undergoing emergency surgery
Patients undergoing concomitant valve surgery
Patients with missing or inconsistent key clinical or laboratory data
The study population will consist of adult patients who underwent elective on-pump coronary artery bypass grafting at University of Health Sciences Bursa Yüksek İhtisas Training and Research Hospital between January 1, 2022 and December 31, 2025. Eligible patients will be identified retrospectively from electronic medical records, laboratory databases, and archived patient files.
Cohort
Retrospective
Early Postoperative Phenotype Classification
Other interventionPatients will be retrospectively classified into phenotype groups based on early postoperative inflammatory and renal biomarker trajectories. This classification is analytical only and does not involve any intervention, treatment assignment, or additional testing.
Number of Participants With Prolonged Postoperative Intensive Care Unit Stay
Prolonged postoperative intensive care unit stay was defined as an intensive care unit length of stay exceeding 4 days after elective on-pump coronary artery bypass grafting.
Acute Kidney Injury
Postoperative acute kidney injury defined according to serum creatinine-based KDIGO criteria within the first 72 hours after elective on-pump coronary artery bypass grafting.
In-Hospital Mortality
Death from any cause occurring after elective on-pump coronary artery bypass grafting.
Reintubation
Requirement for endotracheal reintubation after initial postoperative extubation following elective on-pump coronary artery bypass grafting.
Arrhythmia Requiring Treatment
Occurrence of postoperative arrhythmia requiring medical treatment, electrical cardioversion, or another clinically documented therapeutic intervention after elective on-pump coronary artery bypass grafting.
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