Abstract / Summary
Triglycerides-total Cholesterol-Body weight Index (TCBI, calculated as triglycerides × total cholesterol × body weight / 1000), as a novel nutritional index, was closely associated with prognosis of patients with heart failure and aortic dissection. However, there are no studies on the application of TCBI in patients undergoing coronary artery bypass grafting (CABG). The aim of this study was to investigate the relationship between TCBI and postoperative complications in elderly CABG patients, and to evaluate the predictive value of TCBI for postoperative complications. A retrospective analysis of 343 elderly CABG patients from January 2022 to May 2023 in Wuhan Asian Heart Hospital was conducted. We employed Least Absolute Shrinkage and Selection Operator (LASSO) regression, and multivariate logistic regression analyses to investigate independent influencing factors for postoperative complications in elderly CABG patients. The receiver operating characteristic (ROC) curve and DeLong’ s test were used to compare the predictive effect of TCBI with other nutritional assessment indicators (Controlling Nutritional Status (CONUT) score, Prognostic Nutritional Index (PNI) and Geriatric Nutritional Risk Index (GNRI)) on complications. Postoperative complications occurred in 126 (36.7%) patients. TCBI was an independent influencing factor for complications (OR = 0.995, 95% CI = 0.994–0.997, p < 0.001). Compared with patients in the highest TCBI quartile (Q4), the incidence of complications increased progressively across the lower quartiles ( p < 0.001). The area under the curve (AUC) for TCBI to predict complications in elderly CABG patients was 0.820, which was higher than the other three nutritional assessment indicators (95% CI = 0.777–0.864, p < 0.001). The optimal cut-off value for TCBI was determined to be 510.75, with a sensitivity of 74.7% and specificity of 77.0%. Pairwise DeLong’ s test revealed that the AUC of TCBI was significantly higher than that of CONUT, PNI, and GNRI ( p < 0.001). TCBI may be a novel and effective nutritional assessment indicator for predicting postoperative complications in elderly CABG patients. Healthcare professionals should pay attention to the preoperative TCBI score to reduce the incidence of postoperative complications. Clinical trial number: not applicable.