Mild-to-Moderate COPD as a Risk Factor for Increased 30-Day Mortality in Cardiac Surgery

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is still a serious comorbidity in surgical procedures. We assessed the impact of mild to moderate COPD in a modern cardiac surgery unit. METHODS: An age-, gender- and operation-matched cohort analysis of 242 patients treated between 01/2006 and 12/2008 was performed. COPD was defined as a FEV1 < 80 % and a FEV1/FVC ratio < 0.7 in preoperative spirometry. Primary end point was 30-day mortality. RESULTS: Preoperative beta-agonist treatment of COPD patients was noted for 43 % of patients and not in the control group. After comparable surgery, postoperative respiratory failure was more frequent in COPD patients (10.4 % vs. 2.5 %, P = 0.02), whereas median ventilation time (12 h) and rate of reintubation (2.5 % vs. 3.5 %) did not significantly differ between both groups. Intensive care and hospital stay were significantly longer in the COPD group ( P = 0.02 and P = 0.04), and 30-day mortality was significantly higher in COPD patients (0.8 % vs. 6.1 %, P = 0.03). CONCLUSIONS: COPD increases 30-day mortality, postoperative pulmonary complications, ICU stay and hospital stay. Proper identification and therapy may help to improve outcome in this high-risk population.