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A Journal on Surgery
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Chirurgia 2013 April;26(2):111-4
Chronic obstructive pulmonary disease and coronary surgery
Ergüneş K., Gokalp O., Sahin A., Yurekli I., Ozpak B., Yetkin U., Yilik L., Gurbuz A.
İzmir Katip Çelebi University Atatürk Training and Research Hospital, Department of Cardiovascular Surgery, Izmir, Turkey
Aim: Chronic obstructive pulmonary disease is a risk factor affecting morbidity and mortality in the patients undergoing CABG surgery. We aimed to investigate risk factors for morbidity, mortality and survival in patients with COPD undergoing isolated on-pump coronary artery bypass surgery.
Methods: Between January 2002 and December 2009, 1657 patients underwent isolated CABG in our clinic. COPD was present 4.46% (N.=74) of 1657 patients.
Results: Age, operation time, prolonged inotropic support, use of IABP, prolonged ventilatory support, postoperative renal insufficiency were independent predictive factors among patients with COPD undergoing on-pump CABG (p<0.05). ICU stay, hospital stay and mortality rates were significantly higher among patients with COPD (p=0.000). Prolonged ventilatory support and massive blood transfusion (>3 units) were the independent predictors of length of ICU stay among patients with COPD (p<0.05). CPB time and prolonged ventilatory support were the independent predictors of length of hospital stay among patients with COPD (p<0.05). We stated that postoperative mortality rate was 18.9% (n=14) and 3.1% (n=49) in patients with and without COPD. Morbidity was significantly higher among patients with COPD. Four-years survival rate was 91.1% for patients with COPD and 94.9 for patients without COPD. Advanced age and smoking were risk factors affecting mortality in mid-term follow-up in patients with COPD (p<0.05).
Conclusion: Patients with COPD had higher postoperative mortality and morbidity rates than those without COPD. Mid-term survival rate shorter in patients with COPD.