Key result
Preoperative spirometry-verified airflow obstruction was associated with a significantly higher probability of death in patients undergoing elective cardiac surgery (8.8% vs 4.5%, P=0.04).
Why the study?
Although reduced lung function and COPD are associated with increased mortality after cardiac surgery, preoperative spirometry is not routinely performed. The authors investigated the relationship between preoperative lung function and postoperative complications in all comers for cardiac surgery.
Does preoperative spirometry-verified airflow obstruction predict mortality in all comers for elective adult cardiac surgery?
Observational (n=683)
Does preoperative spirometry-verified airflow obstruction predict mortality in all comers for elective adult cardiac surgery?
Preoperative spirometry identifies undiagnosed airflow obstruction and predicts higher postoperative mortality in elective cardiac surgery patients, suggesting utility for routine preoperative screening.
May identify higher-risk elective cardiac surgery patients; leaves open prospective validation of routine spirometry screening.
OBJECTIVES: Although reduced lung function and chronic obstructive pulmonary disease (COPD) is associated with higher risk of death following cardiac surgery, preoperative spirometry is not performed routinely. The aim of this study was to investigate the relationship between preoperative lung function and postoperative complications in all comers for cardiac surgery irrespective of smoking or COPD history. METHODS: Preoperative spirometry was performed in elective adult cardiac surgery patients. Airflow obstruction was defined as the ratio of forced expiratory volume in 1 s (FEV1)/forced vital capacity ratio below the lower limit of normal (LLN) and reduced forced ventilatory capacity defined as FEV1 <LLN. RESULTS: A history of COPD was reported by 132 (19%) patients; however, only 74 (56%) had spirometry-verified airflow obstruction. Conversely, 64 (12%) of the 551 patients not reporting a history of COPD had spirometry-verified airflow obstruction. The probability of death was significantly higher in patients with airflow obstruction (8.8% vs 4.5%, P = 0.04) and in patients with a FEV1
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Risom et al. (2019) conducted an observational in Elective cardiac surgery (n=683). Preoperative airflow obstruction vs. No airflow obstruction was evaluated on Probability of death (p=0.04). Preoperative spirometry-verified airflow obstruction was associated with a significantly higher probability of death in patients undergoing elective cardiac surgery (8.8% vs 4.5%, P=0.04).
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