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The burden of chronic obstructive pulmonary disease in open heart surgery—a retrospective cohort analysis of postoperative complications: STROBE compliant
Chronic obstructive pulmonary disease (COPD) has a major impact on mortality and morbidity in patients undergoing cardiac surgery. Mortality risk increases by 50% in patients who were re-intubated or required prolonged mechanical ventilation after the operation. The aim of this study was to assess t...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7220196/ https://www.ncbi.nlm.nih.gov/pubmed/32221097 http://dx.doi.org/10.1097/MD.0000000000019675 |
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author | Szylińska, Aleksandra Kotfis, Katarzyna Listewnik, Mariusz Brykczyński, Mirosław Marra, Annachiara Rotter, Iwona |
author_facet | Szylińska, Aleksandra Kotfis, Katarzyna Listewnik, Mariusz Brykczyński, Mirosław Marra, Annachiara Rotter, Iwona |
author_sort | Szylińska, Aleksandra |
collection | PubMed |
description | Chronic obstructive pulmonary disease (COPD) has a major impact on mortality and morbidity in patients undergoing cardiac surgery. Mortality risk increases by 50% in patients who were re-intubated or required prolonged mechanical ventilation after the operation. The aim of this study was to assess the impact of COPD on the prediction of postoperative complications and outcome including intensive care unit (ICU) and hospital stay, postoperative morbidity and mortality in patients undergoing all types of cardiac surgery. We performed a retrospective cohort analysis of prospectively collected data from a tertiary cardiac surgery department of a university hospital between 2014 and 2016. We divided patients undergoing cardiac surgery into 2 sub-groups – the first – with a clinical diagnosis of COPD (n = 198) and the second comprised all other non-COPD patients (n = 2980). Among patients with COPD a longer intubation time (P = .039), longer ICU stay (P < .001) and longer hospitalization time (P = .006) was noted as compared with non-COPD patients. Patients with COPD required reintubation more often than non-COPD patients, reintubation occurring twice, 19 (9.60%) versus 144 (4.83%) P = .002, reintubation occurring 3 or more times, 7 (3.54%) versus 34 (1.14%) P = .006. Mortality within 30 days after surgery was higher in patients with pulmonary problems before surgery (P = .003). Multivariable logistic regression analysis corrected for interfering variables showed an increased risk of postoperative bronchoconstriction (odds ratio [OR] = 4.40, P = .002), respiratory failure (OR = 1.67, P = .018), atrial fibrillation (OR = 1.45, P = .023), and use of hemofiltration (OR = 1.60, P = .029) for patients with COPD. Patients with COPD undergoing all types of cardiac surgery are at increased risk of respiratory complications and mortality. The occurrence of COPD was associated with longer ICU and hospital stay. In COPD patients, undergoing cardiac surgery, treatment strategies aimed at preventing reintubation and early weaning mechanical ventilation must be employed to reduce postoperative complications. |
format | Online Article Text |
id | pubmed-7220196 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-72201962020-06-15 The burden of chronic obstructive pulmonary disease in open heart surgery—a retrospective cohort analysis of postoperative complications: STROBE compliant Szylińska, Aleksandra Kotfis, Katarzyna Listewnik, Mariusz Brykczyński, Mirosław Marra, Annachiara Rotter, Iwona Medicine (Baltimore) 7100 Chronic obstructive pulmonary disease (COPD) has a major impact on mortality and morbidity in patients undergoing cardiac surgery. Mortality risk increases by 50% in patients who were re-intubated or required prolonged mechanical ventilation after the operation. The aim of this study was to assess the impact of COPD on the prediction of postoperative complications and outcome including intensive care unit (ICU) and hospital stay, postoperative morbidity and mortality in patients undergoing all types of cardiac surgery. We performed a retrospective cohort analysis of prospectively collected data from a tertiary cardiac surgery department of a university hospital between 2014 and 2016. We divided patients undergoing cardiac surgery into 2 sub-groups – the first – with a clinical diagnosis of COPD (n = 198) and the second comprised all other non-COPD patients (n = 2980). Among patients with COPD a longer intubation time (P = .039), longer ICU stay (P < .001) and longer hospitalization time (P = .006) was noted as compared with non-COPD patients. Patients with COPD required reintubation more often than non-COPD patients, reintubation occurring twice, 19 (9.60%) versus 144 (4.83%) P = .002, reintubation occurring 3 or more times, 7 (3.54%) versus 34 (1.14%) P = .006. Mortality within 30 days after surgery was higher in patients with pulmonary problems before surgery (P = .003). Multivariable logistic regression analysis corrected for interfering variables showed an increased risk of postoperative bronchoconstriction (odds ratio [OR] = 4.40, P = .002), respiratory failure (OR = 1.67, P = .018), atrial fibrillation (OR = 1.45, P = .023), and use of hemofiltration (OR = 1.60, P = .029) for patients with COPD. Patients with COPD undergoing all types of cardiac surgery are at increased risk of respiratory complications and mortality. The occurrence of COPD was associated with longer ICU and hospital stay. In COPD patients, undergoing cardiac surgery, treatment strategies aimed at preventing reintubation and early weaning mechanical ventilation must be employed to reduce postoperative complications. Wolters Kluwer Health 2020-03-27 /pmc/articles/PMC7220196/ /pubmed/32221097 http://dx.doi.org/10.1097/MD.0000000000019675 Text en Copyright © 2020 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by/4.0 This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0 |
spellingShingle | 7100 Szylińska, Aleksandra Kotfis, Katarzyna Listewnik, Mariusz Brykczyński, Mirosław Marra, Annachiara Rotter, Iwona The burden of chronic obstructive pulmonary disease in open heart surgery—a retrospective cohort analysis of postoperative complications: STROBE compliant |
title | The burden of chronic obstructive pulmonary disease in open heart surgery—a retrospective cohort analysis of postoperative complications: STROBE compliant |
title_full | The burden of chronic obstructive pulmonary disease in open heart surgery—a retrospective cohort analysis of postoperative complications: STROBE compliant |
title_fullStr | The burden of chronic obstructive pulmonary disease in open heart surgery—a retrospective cohort analysis of postoperative complications: STROBE compliant |
title_full_unstemmed | The burden of chronic obstructive pulmonary disease in open heart surgery—a retrospective cohort analysis of postoperative complications: STROBE compliant |
title_short | The burden of chronic obstructive pulmonary disease in open heart surgery—a retrospective cohort analysis of postoperative complications: STROBE compliant |
title_sort | burden of chronic obstructive pulmonary disease in open heart surgery—a retrospective cohort analysis of postoperative complications: strobe compliant |
topic | 7100 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7220196/ https://www.ncbi.nlm.nih.gov/pubmed/32221097 http://dx.doi.org/10.1097/MD.0000000000019675 |
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