title: The correlation between preoperative erythrocyte sedimentation rate and postoperative outcome in adult cardiac surgery.
abstract: BACKGROUND
  Over the past decades, it has been recommended that preoperative assessment mainly relies on history and physical examination rather than unnecessary laboratory tests. In Iranian hospitals, erythrocyte sedimentation rate (ESR) has been routinely measured in most of the patients awaiting major surgery, which has in turn exacted heavy costs on the health system. Therefore, the aim of the present study was to assess the preoperative routine measurement of ESR in such patients.
  
  
  METHODS
  This is a retrospective study, in which we evaluated the medical files of 620 patients. Patients older than 18 years, who had undergone elective heart surgery in our hospital in 2014, were included in the study. The data associated with demography, heart disease diagnosis, type of surgery, significant preoperative tests, delay or postponing of surgery and the reason for it, type and characteristics of the subspecialty consultation, and finally, postoperative complication and mortality rate were collected and analyzed. The patients were categorized into four groups according to ESR value: normal (<15 mm/h in females or <20 mm/h in males), moderately increased (<40 mm/h), severely increased (≥40 mm/h), and not measured.
  
  
  RESULTS
  Of the 620 patients' files, 402 were of males and 218 were of females. Demographic values and preoperative characteristics were similar in the four groups. A total of 105 consultations were given to 79 patients preoperatively, where only in five cases, the elevation in ESR was the main reason for consultation. In no other cases did the consultations result in new diagnoses. Overall, postoperative complication and mortality rate were the same in all four groups; in severely increased ESR group, on the other hand, the need for long periods of intensive care unit (ICU) and hospital stays was higher than that of other groups.
  
  
  CONCLUSIONS
  It is concluded that elevated preoperative ESR does not cancel or defer the surgery, nor does it help diagnose a new, previously undiagnosed disease. Furthermore, it does not generally affect postoperative morbidity or mortality rate unless increased to ≥40 mm/h, where it can increase postoperative ICU and hospital stay. Ultimately, routine preoperative ESR measurement in patients is not conducive to elective heart surgery.
authors.affiliation: Department of Anesthesiology, Tabriz University of Medical Sciences, Tabriz.
authors.forename: Eissa
authors.initials: E
authors.lastname: Bilehjani
authors.affiliation: Department of Anesthesiology, Tabriz University of Medical Sciences, Tabriz.
authors.forename: Solmaz
authors.initials: S
authors.lastname: Fakhari
authors.affiliation: Department of Anesthesiology, Tabriz University of Medical Sciences, Tabriz.
authors.forename: Haleh
authors.initials: H
authors.lastname: Farzin
authors.affiliation: Department of Cardiovascular Surgery, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Alireza
authors.initials: A
authors.lastname: Yaghoubi
authors.affiliation: Department of Anesthesiology, Tabriz University of Medical Sciences, Tabriz.
authors.forename: Moussa
authors.initials: M
authors.lastname: Mirinazhad
authors.affiliation: Department of Anesthesiology, Tabriz University of Medical Sciences, Tabriz.
authors.forename: Kamran
authors.initials: K
authors.lastname: Shadvar
authors.affiliation: Department of Anesthesiology, Tabriz University of Medical Sciences, Tabriz.
authors.forename: Abbasali
authors.initials: A
authors.lastname: Dehghani
authors.affiliation: Department of Anesthesiology, Tabriz University of Medical Sciences, Tabriz.
authors.forename: Pariasadat
authors.initials: P
authors.lastname: Aboalaiy
keywords: erythrocyte sedimentation rate; heart surgery; postoperative complication; postoperative mortality