Abstract
Objective: To determine the prognostic value of soluble urokinase plasminogen activator receptor (suPAR) on morbidity and mortality related to the intensive care unit (ICU) length of stay, hospital length of stay, and postoperative complications in adult cardiac surgery patients.
Design: This study used an analytic observational design with a prospective cohort approach.
Setting: This study was conducted at Dr. Wahidin Sudirohusodo Hospital, Makassar, from December 2024 to March 2025.
Patients: This study involved 40 adult cardiac surgery patients who met the inclusion criteria.
Measurements: SuPAR levels were measured in blood samples obtained before induction of anesthesia and 24 hours postoperatively using an enzyme-linked immunosorbent assay (ELISA). Other data collected included age, gender, body mass index (BMI), presence of comorbidities, New York Heart Association (NYHA) cardiac classification, type of adult cardiac surgical operation, and European System for Cardiac Operative Risk Evaluation (EuroSCORE) II. In addition, postoperative data were collected, and mortality was followed for 30 days postoperatively using Kaplan-Meier survival analysis.
Results: SuPAR levels showed significant associations with length of hospitalization, length of hospital stay, and duration of mechanical ventilation (p<0.05). Patients with a longer length of stay consistently had higher suPAR levels. Significant differences were also found between preoperative and postoperative suPAR levels regarding mortality (p<0.05). Preoperative suPAR showed acceptable performance in predicting mortality, as indicated by the area under the curve (AUC). Kaplan-Meier survival analysis showed that higher suPAR levels were associated with a lower probability of 30-day postoperative survival. However, suPAR showed no significant association in predicting postoperative stroke or deep sternal wound infection.
Conclusions: SuPAR has significant prognostic value for predicting ICU length of stay, hospital length of stay, mechanical ventilation duration, and mortality in adult cardiac surgery patients. However, no significant association was found between suPAR and postoperative stroke or deep sternal wound infection. Therefore, suPAR serves as an important biomarker to assess prognosis in adult cardiac surgery patients.
Ahmad Pathoni, Syafri K. Arif, Faisal Muchtar, Hisbullah, Haizah Nurdin, Andi Adil
