Chronic obstructive pulmonary disease in patients undergoing coronary artery bypass grafting

The purpose of this study was to evaluate the effect of chronic obstructive pulmonary disease on patients undergoing coronary artery bypass grafting. Between June 1991 and June 1993, 651 patients underwent coronary artery bypass grafting: 37 patients (group I) had significant chronic obstructive pul...

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Bibliographic Details
Published in:	The Journal of thoracic and cardiovascular surgery Vol. 109; no. 3; pp. 574 - 581
Main Authors:	Cohen, Amram, Katz, Michael, Katz, Ramah, Hauptman, Eli, Schachner, Arieh
Format:	Journal Article
Language:	English
Published:	Philadelphia, PA Mosby, Inc 01-03-1995 AATS/WTSA Elsevier
Subjects:	Aged Arrhythmias, Cardiac - etiology Biological and medical sciences Cardiology. Vascular system Case-Control Studies Coronary Artery Bypass - adverse effects Coronary Artery Bypass - mortality Coronary Disease - complications Coronary Disease - surgery Coronary heart disease Female Follow-Up Studies Heart Humans Lung Diseases, Obstructive - complications Male Medical sciences Middle Aged Postoperative Complications - epidemiology Postoperative Complications - etiology Postoperative Complications - mortality Risk Factors Human Respiratory disease Mortality Cardiovascular disease Coronary heart disease Morbidity Concomitant disease Chronic Treatment Aortocoronary Bypass Surgery Obstructive pulmonary disease Comparative study
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Summary:	The purpose of this study was to evaluate the effect of chronic obstructive pulmonary disease on patients undergoing coronary artery bypass grafting. Between June 1991 and June 1993, 651 patients underwent coronary artery bypass grafting: 37 patients (group I) had significant chronic obstructive pulmonary disease. These patients were compared with 37 matched control subjects (group II). Comparison of the groups was made with regard to postoperative morbidity and mortality. Quality of life of survivors was compared at the last follow-up. More patients in group I had preoperative arrhythmias (8 versus 1, p = 0.014). Group I patients had lower values of forced expiratory volume in 1 second (1.366 ± 0.032 L versus 2.335 ± 0.49 L, p < 0.0001), lower oxygen tension (63.5 ± 8.2 versus 79.1 ± 13.4 mm Hg, p = 0.001), and higher carbon dioxide tension (44.8 ± 6.5 mm Hg versus 39.7 ± 3.6 mm Hg, p = 0.001). After operation patients in group I had a longer hospital stay (8.1 ± 3.6 days versus 6.6 ± 1.7 days, p = 0.0236) and longer intensive care unit stay (2.64 ± 0.9 days versus 1.23 ± 0.49 days, p = 0.0001). More patients in group I required prolonged intubation (7 versus 1, p = 0.0278) and reintubation (5 versus 1, p = 0.088). More patients in group I had significant arrhythmias (27 versus 9, p < 0.0001). During a 16-month follow-up period, five patients in group I died, whereas none in group II died ( p = 0.0271). Four deaths were related to arrhythmias. More group I patients were not functionally improved by the operation (17 versus 3, p = 0.0056). The results of coronary artery bypass grafting in patients with significant chronic obstructive pulmonary disease were not favorable in midterm follow-up. A major cause for morbidity and mortality was postoperative arrhythmias. (J T HORAC C ARDIOVASC S URG 1995; 109: 574-81)
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0022-5223 1097-685X
DOI:	10.1016/S0022-5223(95)70291-1