Intra-operative phrenic nerve injury (OR 4.59), older age (OR 3.31), and postoperative acute kidney injury (OR 3.21) were identified as significant independent risk factors for pulmonary complications following cardiac surgery with cardiopulmonary bypass.
Observational (n=2,056)
No
Older age, preoperative congestive heart failure, low preoperative PaO2, prolonged cardiopulmonary bypass, intra-operative phrenic nerve injury, and postoperative acute kidney injury independently increase the risk of pulmonary complications following cardiac surgery with CPB.
Odds Ratio: 4.59 (95% CI 2.52–9.24)
p-value: p=0.0046
BACKGROUND: Pulmonary complications following cardiac surgery with cardiopulmonary bypass (CPB) are often associated with significant morbidity and mortality. However, few reports have focused on evaluating intra- and post-operative independent risk factors for pulmonary complications following cardiac surgery with CPB. This study aimed to evaluate peri-operative independent risk factors for postoperative pulmonary complications through investigating and analyzing 2056 adult patients undergoing cardiac surgery with CPB. METHODS: From January 2005 to December 2012, the relevant pre-, intra-, and post-operative data of adult patients undergoing cardiac surgery with CPB in the department of cardiovascular surgery of Tongji Hospital of Tongji University in Shanghai were investigated and retrospectively analyzed. The independent risk factors for pulmonary complications following cardiac surgery with CPB were obtained through descriptive analysis and then logistic regression analysis. RESULTS: One hundred and forty-three adult patients suffered from pulmonary complications following cardiac surgery with CPB, with an incidence of 6.96%. Through descriptive analysis and then logistic regression, independent risk factors for postoperative pulmonary complications were as follows: older age (>65 years) (OR=3.31, 95%CI 1.71-7.13), preoperative congestive heart failure (OR=2.95, 95%CI 1.41-5.84), preoperative arterial oxygenation (PaO2) (OR=0.67, 95%CI 0.33-0.85), duration of CPB (OR=3.15, 95%CI 1.55-6.21), intra-operative phrenic nerve injury (OR=4.59, 95%CI 2.52-9.24), and postoperative acute kidney injury (OR=3.21, 95%CI 1.91-6.67). Postoperative pulmonary complication was not a risk factor for hospital death (OR=2.10, 95%CI 0.89-4.33). CONCLUSIONS: A variety of peri-operative factors increased the incidence of pulmonary complications following cardiac surgery with cardiopulmonary bypass.
Ji et al. (2013) conducted an observational in Cardiac surgery with cardiopulmonary bypass (n=2,056). Intra-operative phrenic nerve injury vs. No intra-operative phrenic nerve injury was evaluated on Postoperative pulmonary complications (pneumonia and respiratory failure) (OR 4.59, 95% CI 2.52-9.24, p=0.0046). Intra-operative phrenic nerve injury (OR 4.59), older age (OR 3.31), and postoperative acute kidney injury (OR 3.21) were identified as significant independent risk factors for pulmonary complications following cardiac surgery with cardiopulmonary bypass.