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Postoperative pulmonary complications in cardiac surgery patients: a prospective cohort, single-centre study


Cueva, L. F.; Bausili, M.; González, R.; Ardila, C.; Galán, J.

European Journal of Anaesthesiology (EJA): June 2014 - Volume 31 - Issue - p 80

Hospital de la Santa Creu i Sant Pau, Dept of Anaesthesiology & Pain Medicine, Barcelona, Spain

Background and Goal of Study: Postoperative pulmonary complications (PPC) in cardiac surgery increase morbidity and mortality. However, few reports have evaluated pre-, intra- and post-operative independent risk factors (IRF) for PPC. We aimed to determine the incidence of PPC and peri-operative independent risk factors for PPC in cardiac surgery patients.

Materials and methods: We performed a single-centre, prospective, cohort study of patients undergoing cardiac surgery at our centre from January to December 2012. Main outcome was the development of at least one of the following: respiratory failure, respiratory infection, bronchospasm and atelectasis. (Table 1) Data were obtained through descriptive and logistic regression analysis.



Results and discussion: A total of 393 patients underwent cardiac surgery. We excluded 33 patients who required urgent surgery or reoperation, had massive bleeding, or was lost to follow-up. Of the remaining 357 patients, 191 (53%) developed PPC following cardiac surgery. Significant independent risk factors for PPC were: age >80 years (OR=2.52, 95%CI 1.06 - 5.94), obesity >30 BMI (OR= 3.06, 95%CI 1.78-5.28), preoperative SpO2< 96% (OR=2.2, 95%CI 1.21-4.11), and OSAS (OR=5.24, 95%CI 1.18-23.41).

Conclusion(s): The incidence of PPC after cardiac surgery was high in our centre. Modifiable IRF should be optimized before cardiac surgery, and nonmodifiable IRF could be treated with prophylactic measures.

© 2014 European Society of Anaesthesiology