• J. Cardiothorac. Vasc. Anesth. · Oct 2018

    Chronic Lung Disease and Mortality after Cardiac Surgery: A Prospective Cohort Study.

    • Dmitry Ponomarev, Oksana Kamenskaya, Asya Klinkova, Irina Loginova, Pavel Vedernikov, Igor Kornilov, Vladimir Shmyrev, Vladimir Lomivorotov, Aleksander Chernavskiy, and Aleksander Karaskov.
    • Department of Anesthesia and Intensive Care, Meshalkin National Medical Research Centre, Novosibirsk, Russia. Electronic address: d_ponomarev@meshalkin.ru.
    • J. Cardiothorac. Vasc. Anesth. 2018 Oct 1; 32 (5): 2241-2245.

    ObjectiveTo investigate the 1-year survival in cardiac surgical patients with lung disease, including previously undiagnosed cases.DesignProspective cohort study.SettingTertiary hospital.ParticipantsPatients scheduled for elective coronary artery bypass graft (CABG) surgery.InterventionsNone.Measurements And Main ResultsPulmonary function tests (PFTs) were performed in 454 patients before surgery. Abnormal respiratory patterns were defined as follows: obstructive (forced expiratory volume in 1 second/forced vital capacity <0.70), restrictive (forced expiratory volume in 1 second/forced vital capacity ≥0.70 and forced vital capacity <80% of predicted), and mixed. Overall 1-year mortality was 3.3%. Among 31 patients with documented chronic obstructive pulmonary disease (COPD), mortality was 9.6%, hazard ratio (HR) 1.28, 95% confidence interval (CI) 1.02-12.80, p = 0.04. Of 423 patients without history of COPD, 57 obstructive, 46 restrictive, and 4 mixed abnormal patterns were identified. Of a total of 72 with obstructive lung disease confirmed by PFT (ie, 15 of COPD patients and 57 newly identified cases), 6.9% died, HR 2.75, 95% CI 0.98-8.07, p = 0.06. When combined with cases of COPD where a respiratory abnormality was confirmed (26 patients), newly diagnosed obstructive lung disease (57 patients) was significantly associated with 1-year mortality, HR 4.13, 95% CI 1.50-11.42, p = 0.006. The adjustment for EuroSCORE II did not change the results.ConclusionsCombination of confirmed preexisting lung disease and newly diagnosed cases provides a clear link to mid-term mortality.Copyright © 2017 Elsevier Inc. All rights reserved.

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