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The Journal of Cardiovascular Surgery 2010 December;51(6):915-21

Copyright © 2010 EDIZIONI MINERVA MEDICA

lingua: Inglese

Pulmonary function and immediate and late outcome after coronary artery bypass surgery

Nissinen J. 1, 5, Biancari F. 2, Wistbacka J. O. 3, Loponen P. 1, 5, Kairi P. 3, Korpilahti K. 4, Tarkka M. 5

1 Department of Thoracic and Vascular Surgery, Vaasa Central Hospital, Vaasa, Finland; 2 Department of Surgery, Oulu University Hospital, Oulu, Finland; 3 Department of Anesthesiology, Vaasa Central Hospital, Vaasa, Finland; 4 Department of Cardiology, Vaasa Central Hospital, Vaasa, Finland; 5 Department of Cardiothoracic Surgery, Heart Center, Tampere University Hospital, Tampere, Finland


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AIM: The aim of this study was to evaluate whether pulmonary function as assessed by spirometry affects the immediate and late outcome after isolated coronary artery bypass surgery (CABG).
METHODS: Data on preoperative percentages of the predicted forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) were retrieved from a series of 1 848 patients who underwent isolated CABG. Pulmonary disease was defined according to EuroSCORE criteria.
RESULTS: Logistic regression showed that percentage of predicted FVC was an independent predictor of in-hospital mortality along with estimated glomerular filtration rate, age and extracardiac arteriopathy. Cox regression analysis showed that pulmonary disease and percentages of predicted FVC were independent predictors of late overall mortality. Percentage of predicted FVC <70% (at 10-year: 63.8% vs. 74.3%, Cox regression analysis: P=0.014, RR 1.50, 95%C.I. 1.08-2.08) and pulmonary disease (at 10-year: 58.0% vs. 76%, Cox regression analysis: P<0.0001, RR 1.75, 95%C.I. 1.29-2.39), but not percentage of predicted FEV1 <70%, were associated with a marked decrease in late survival.
CONCLUSION: This study confirmed the significant, negative prognostic impact of pulmonary disease on the immediate and long-term survival after isolated CABG.

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