• Béla Fülesdi, György Koszta, Zoltán Kacska, Katalin Szatmári, and Tamás Szerafin.
• Department of Anesthesia and Intensive Care, University of Debrecen, Medical and Health Science Centre, 4032 , Nagyerdei krt. 98, Debrecen, Hungary. kosztagy@gmail.com
• J Anesth. 2012 Dec 1;26(6):812-21.

PurposeThe authors intended to test their hypothesis that a low blood selenium level is associated with higher mortality, morbidity, and increased inflammatory response following cardiac surgery.MethodsA single-center clinical survey was conducted on 197 consecutive patients undergoing on-pump operation in Debrecen, Hungary. Blood samples for whole blood selenium analysis were taken immediately before the surgery. Their risk profiles were evaluated according to the EuroSCORE. The outcome parameters were as follows: 30-day mortality, incidence of systemic inflammatory response syndrome, and cardiac and renal dysfunction. The main laboratory outcome variables were the postoperative concentrations of C-reactive protein and cardiac troponin I.ResultsThe mean blood selenium level was significantly lower in non-survivors 102.2 ± 19.5 μg/L compared with survivors 111.1 ± 16.9 μg/L (p = 0.047), and the mean age, EuroSCORE values, and troponin concentrations were significantly higher in the non-survivors. To exclude these potential confounders a logistic regression model was fitted to our data, with mortality as the outcome and the EuroSCORE, the degree of troponin elevation, and selenium concentration as explanatory variables. This model revealed that a lower selenium level was a minor but apparently existing risk factor for postoperative mortality.ConclusionFurther examinations are required to clarify the question that remained unanswered in this study: the role of low selenium in the causality chain leading to higher postoperative mortality.

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