Influence of age-specific lung function on survival after coronary bypass

Canver, Charles C.; Nichols, Ronald; Kroncke, George M.

doi:10.1016/s0003-4975(98)00322-1

Cited by 35 publications

(24 citation statements)

References 8 publications

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“…The incidence of complications increases with patient age and the severity of chronic obstructive pulmonary disease, as measured with pulmonary function testing. 1204,1205 None of these studies, however, address the relative risks and benefits of CABG in subjects with chronic obstructive pulmonary disease, thereby precluding a specific recommendation regarding the performance of CABG in these patients. In preparation for CABG, optimizing pulmonary function is imperative.…”

Section: Patients With Diabetes Mellitusmentioning

confidence: 99%

2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery

et al. 2011

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Section: Patients With Diabetes Mellitusmentioning

confidence: 99%

2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery

et al. 2011

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“…Canver clearly showed that FEV 1 of Ͻ1.5 L is a significant predictor of decreased 5-year survival. 11 As with any disease, there is a spectrum of severity in patients with COPD in our database. The patient on home oxygen with a severely depressed FEV 1 is much different than the patient who is on an inhaler only.…”

Section: Study Limitationsmentioning

confidence: 99%

“…9 Two studies demonstrate no increase in in-hospital mortality in patients with COPD compared with patients without COPD. 10,11 More recently, 2 prospective analyses of large cardiac registries have reported increased odds of in-hospital mortality by ratios of 1.4 to 1.6 among patients with COPD compared with patients without COPD. 12,13 The published literature is sparse with respect to the long-term survival of patients with COPD who undergo CABG surgery.…”

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confidence: 99%

Long-Term Survival of Patients With Chronic Obstructive Pulmonary Disease Undergoing Coronary Artery Bypass Surgery

et al. 2006

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Background— Chronic obstructive pulmonary disease (COPD) is associated with increased in-hospital mortality in patients undergoing coronary artery bypass surgery (CABG). Long-term survival is less well understood. The present study examined the effect of COPD on survival after CABG. Methods and Results— We conducted a prospective study of 33 137 consecutive isolated CABG patients between 1992 and 2001 in northern New England. Records were linked to the National Death Index for long-term mortality data. Cox proportional hazards regression was used to calculate hazard ratios (HRs). Patients were stratified by: no comorbidities (none), COPD, COPD plus comorbidities, and other comorbidities with no COPD. There were 131 434 person years of follow-up and 5344 deaths. The overall incidence rate (deaths per 100 person years) was 4.1. By group, rates were: 2.1 (none), 4.0 (COPD alone), 5.5 (other), and 9.4 (COPD plus; log rank P <0.001). After adjustment, survival with COPD alone was worse compared with none (HR, 1.8; 95% CI, 1.6 to 2.1; P <0.001). Patients with other comorbidities compared with none had even worse survival (HR, 2.2; 95% CI, 2.1 to 2.4; P <0.001). Patients with COPD plus other comorbidities compared with none had the worst long-term survival (HR, 3.6; 95% CI, 3.3 to 3.9; P <0.001). Conclusions— Patients with only COPD had significantly reduced long-term survival compared with patient with no comorbidities. Patients with COPD and ≥1 other comorbidity had the worst survival rate when compared with all of the other groups.

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“…It is known that severe pulmonary complications after CABG are more likely to occur in patients with COPD, which has largely been regarded as a risk factor for early mortality. 23) Charles, et al 24) demonstrated that COPD was associated with increased length of ICU stay and hospital stay, irrespective of the patient's age. A preoperative forced expiratory volume in 1 sec significantly affected hospital stay in patients < 70 years of age (p = 0.0001).…”

Section: Discussionmentioning

confidence: 99%

Predictive Risk Factors for Pulmonary Oxygen Transfer in Patients Undergoing Coronary Artery Bypass Grafting.

et al. 2001

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SUMMARYThe ratio of arterial oxygen tension to inspired oxygen fraction (PaO 2 / FiO 2 ) is a useful indicator for weaning patients from mechanical ventilation and a reliable predictor of pulmonary dysfunction after cardiac surgery. The aim of this study was to elucidate the patient characteristics and variables that affect the PaO 2 / FiO 2 ratio.Between 1994-1998, 167 patients who underwent coronary artery bypass grafting (CABG) were examined retrospectively. Spearman's correlation coefficients were calculated between the PaO 2 / FiO 2 ratio and intubation period, and length of ICU stay. Patients were then divided into two groups with a PaO 2 / FiO 2 ratio < 350 and PaO 2 / FiO 2 ratio ≥ 350. Univariate analysis of the putative risk factors was performed. A logistic regression model was developed to evaluate factors that would influence the PaO 2 / FiO 2 ratio.A significant correlation was observed between the PaO 2 / FiO 2 ratio and intubation period, and length of ICU stay. Univariate predictors of a PaO 2 / FiO 2 ratio < 350 were low body weight, low preoperative PaO 2 , long operation time, high FiO 2 , low postoperative PaO 2 , history of smoking, hypertension and opening of pleura (p < 0.05). Excellent prediction was found with a model consisting of preoperative PaO 2 and hypertension.Conclusion: The results of this study suggest that patients with a low preoperative PaO 2 or hypertension may need more careful peri-and postoperative management since these factors are closely associated with the PaO 2 / FiO 2 ratio. (Jpn Heart J 2001; 42: 143-153)

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Influence of age-specific lung function on survival after coronary bypass

Cited by 35 publications

References 8 publications

2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery

2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery

Long-Term Survival of Patients With Chronic Obstructive Pulmonary Disease Undergoing Coronary Artery Bypass Surgery

Predictive Risk Factors for Pulmonary Oxygen Transfer in Patients Undergoing Coronary Artery Bypass Grafting.

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