Risk Factors for Postoperative Respiratory Mortality and Morbidity in Patients Undergoing Coronary Artery Bypass Grafting

Rajaei, Samira; Dabbagh, Ali

doi:10.5812/aapm.5228

Cited by 23 publications

(17 citation statements)

References 55 publications

(123 reference statements)

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“…1 In order to cope the disease, coronary artery bypass grafting (CABG) was introduced as a novel advanced treatment in which, the patient undergoes general anesthesia. Usually the surgeon carries out sternotomy procedure and then the patient is attached to a cardio-respiratory bypass machine.…”

Section: Introductionmentioning

confidence: 99%

“…5,6 The PC after cardiac surgery leads to heavy socio-economic burdens such as prolonged hospitalization, ICU admission, enormous costs of treatment, loss of the work days and even death, if the patient is not properly managed. 1 Several conventional techniques have been proposed in the control of lung function postoperative, including the mucus suction, airway positive pressure exercise, physical therapy, to name a few. 5 At present, various thoracic cavity physiotherapy techniques are used in order to increase the respiratory volumes, improve oxygenation and decrease respiratory complications after CABG 7 ; however, despite the common use of respiratory exercises in patients after CABG in different countries, there is still insufficient scientific evidence for their efficacy.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Effect of Respiratory Rehabilitation before Open Cardiac Surgery on Respiratory Function: A Randomized Clinical Trial

Shakuri¹,

Salekzamani²,

Taghizadieh³

et al. 2015

J Cardiovasc Thorac Res

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effect of Respiratory Rehabilitation before Open Cardiac Surgery on Respiratory Function: A Randomized Clinical Trial

Shakuri¹,

Salekzamani²,

Taghizadieh³

et al. 2015

J Cardiovasc Thorac Res

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“…Postoperative complications tend to occur more frequently with higher BMI patients; however, this did not affect the overall mortality. Previous study showed an increased mortality in obese patients [17] and this was attributed to the severity of CAD in these patients. Obesity can affect long-term survival which was not studied in our series.…”

Section: Ef: Ejection Fractionmentioning

confidence: 93%

Effect of Body Mass Index on Morbidity and Mortality in Patients Undergoing Coronary Artery Bypass Grafting

Shawky

Rizk

Saffan

et al. 2019

Egypt. Cardiothoracic. Surg.

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Background: Obesity affects cardiovascular morbidity and mortality, and it increases the risk of coronary artery disease. Despite that, several cardiac surgery risk stratification scores do not consider the effect of obesity on the outcomes. The objective of this research is to study the impact of body mass index (BMI) on morbidity and mortality after coronary artery bypass grafting (CABG) in Egyptian patients. Methods: This prospective cohort study included 200 patients who underwent CABG for atherosclerotic coronary artery disease. Patients were divided into two groups, group A: patients with BMI ≥ 25 Kg/m2 and group B: patients with BMI < 25 Kg/m2. The mean age in group A was 56± 4.95 years vs. 54± 5.5 years in group B (p= 0.102). Male patients presented 58% of the population in group A vs 74% in group B (p= 0.017). 60% of patients were hypertensive in group A compared to 63% in group B (p= 0.66) and 62%, and 48% were diabetics in group A and B respectively (p= 0.04). Results: Postoperatively, there was a significant increase in wound infection (40% vs 8%; p< 0.001), chest infection (47% vs. 10% p< 0.001), surgical re-exploration (28% vs. 1%; p< 0.001), prolonged ICU stays (5.3 ± 2.88 vs. 3.93 ± 1.71 days; p< 0.001), ward stay (11.28 ±8.9 vs. 5.48 ± 2.45 days; p< 0.001), mediastinitis (34% vs. 6%; p< 0.001), the occurrence of sternal wound sinus within 8 months (26% vs. 7%; p< 0.001), in group A more compared to group B. There was no difference in ejection fraction (54.2 ±7.38 vs. 54.7 ± 9.1%; p= 0.69) and mortality (4% vs. 2%; p= 0.68) between groups. Conclusions: BMI 25 Kg/m2 or higher is associated with increased infectious complications and prolonged stay after CABG; however, it did not affect mortality. Optimizing body weight is recommended before elective surgery.

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“…Postoperative respiratory morbidity and mortality is a multifactorial concept. Patients need to be evaluated thoroughly for multi-system problems (14). We believe that these pulmonary complications may be related to the performance of the heart, and both the operation and the low-performing heart may cause congestion and pulmonary problems.…”

Section: Discussionmentioning

confidence: 99%

Readmission To Intensive Care Unit After Coronary Bypass Operations in the Short Term

Gümüş¹,

Polat²,

Yektaş³

et al. 2014

Turk J Anesth Reanim

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Objective: Intensive care unit (ICU) readmissions after coronary bypass (CABG) operations occur in a significant number of patients, and the prognosis is poor. We analyzed the risk factors for ICU readmissions after CABG operations. Methods:We retrospectively analyzed the prospectively collected data of 679 coronary bypass patients operated in a single institution in order to evaluate the risk factors for readmittance to the ICU with logistic regression analysis. The outcome results of patients readmitted to the ICU (Group R) and others (Group N) were compared.Results: Thirty-six (5.3%) patients were readmitted to the ICU. Postoperative in-hospital mortality and pulmonary and neurologic morbidity occurred in 43 (6.3%), 135 (19.9%), and 46 (6.8%) patients, respectively. The comparison of groups showed that mortality and morbidity were significantly higher in Group R compared to Group N (mortality 16.7% vs. 5.9, p=0.029; pulmonary morbidity 66.7% vs. 17.3%, p=0.0001; neurologic morbidity 38.9% vs. 5.0%, p=0.0001). Features associated with readmission included presence of left ventricular dysfunction preoperatively[odds ratio (OR)=4.1; 95% confidence interval (CI)=1.4-12.5; p=0.013], advanced NYHA Class (OR=5.3; 95% CI=1.3-21.7; p=0.022), pulmonary complications (OR=7.3; 95% CI=2.1-25.5; p=0.002), and neurologic complications (OR=4.6; 95% CI=1.3-16.7; p=0.021). Conclusion:Patients readmitted to the ICU postoperatively have higher rates of mortality and pulmonary and neurologic morbidity after coronary bypass operations. Left ventricular dysfunction, advanced NYHA class, and postoperative pulmonary and neurologic complications are significant risk factors for readmission to the ICU.Key Words: Coronary artery bypass, readmission, intensive care, risk factors Abstract Introduction I n the postoperative recovery period, intensive care unit (ICU) stay is necessary after coronary bypass (CABG) operations in the majority of centers. Particularly, the first few hours are critical for the risk of myocardial ischemia (1). Numerous postoperative problems have to be addressed correctly in this early postoperative period, such as hypertension, arrhythmias, bleeding, and so forth. Patients are transferred to the ICU on mechanical ventilation, and the sedated and intubated patient requires extreme caution during ICU care and extubation.During the recovery period, however, some problems may be encountered, so that patients may have to be readmitted to the ICU. Readmission to the ICU is associated with worse outcome (2). There are studies analyzing ICU readmissions in cardiac surgery patients (1-3); however, they are mostly focused on the fast track protocols. In our clinic, fast track protocols are not employed. Again, ICU readmissions occur in a significant number of patients, and the prognosis is also poor. We analyzed the risk factors for ICU readmissions after a heterogeneous group of CABG operations in a single institution. MethodsAfter approval by the institutional ethics board (Bağcılar Training and Research Hospital, Nonin...

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Risk Factors for Postoperative Respiratory Mortality and Morbidity in Patients Undergoing Coronary Artery Bypass Grafting

Cited by 23 publications

References 55 publications

Effect of Respiratory Rehabilitation before Open Cardiac Surgery on Respiratory Function: A Randomized Clinical Trial

Effect of Respiratory Rehabilitation before Open Cardiac Surgery on Respiratory Function: A Randomized Clinical Trial

Effect of Body Mass Index on Morbidity and Mortality in Patients Undergoing Coronary Artery Bypass Grafting

Readmission To Intensive Care Unit After Coronary Bypass Operations in the Short Term

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