The influence of chronic obstructive pulmonary disease in patients undergoing coronary artery bypass graft surgery
The influence of chronic obstructive pulmonary disease in patients undergoing coronary artery bypass graft surgery
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慢性阻塞性肺疾病对冠状动脉搭桥手术患者的影响
DOI：
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发表时间：
2010
期刊：
影响因子：
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通讯作者：
A. Engel
中科院分区：
文献类型：
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作者：
S. Woods;T. Bolden;A. Engel
本研究的目的是评估接受冠状动脉旁路移植术的COPD患者与非COPD患者之间是否存在任何差异。我们进行了一项前瞻性住院队列研究。研究人群为心胸外科组接受CABG的患者。入选标准包括1993年10月1日至1998年1月1日之间的CABG手术，年龄大于18岁。排除标准包括与CABG手术同时进行的任何其他手术、重复手术和COPD变量数据不完整的任何患者。数据收集225个变量同时入院。我们控制了七个变量。主要结局为30天死亡率。有8个次要结局。10，414例患者符合纳入队列的标准（1，739例COPD患者和阳性吸烟史，8，675例无COPD患者）。单变量分析比较了COPD患者和非COPD患者的7个潜在混杂因素，发现两个人群之间无显著差异。接受CABG手术的COPD患者住院时间明显延长（6.7 ± 6.0天vs. 5.9 ± 6.1天，p < 0.05），术后更可能显著升高肌酐（OR 1.46，95% CI 1.15 - 1.85），通气时间延长（OR 1.99，95% CI 1.60 - 2.49），更容易患肺炎（OR 2.99，95% CI 2.25至3.96）和显著更高的死亡率（OR 1.78，（95% CI 1.32至2.40）。与非COPD患者相比，接受CABG手术的COPD患者的死亡率和发病率显著更高。
The objective of this study was to assess if there are any differences between patients undergoing coronary artery bypass graft surgery with COPD compared to patients without COPD. We conducted a prospective hospitalization cohort study. The study population was patients undergoing CABG by the Cardiovascular Thoracic Surgery Group. Inclusion criteria included CABG surgery between 10/1/93 and 1/1/8 and age greater than eighteen. Exclusion criteria included any other surgery performed simultaneously with the CABG surgery, repeat procedures, and any patient with incomplete data for the COPD variable. Data were collected on 225 variables concurrently with admission. We controlled for seven variables. The primary outcome was thirty-day mortality. There were eight secondary outcomes. Ten thousand, four hundred and fourteen patients meet the criteria to be included in the cohort, (1,739 with COPD and a positive smoking history, 8,675 patients without COPD). Univariate analysis comparing the patients with and without COPD for the seven potential confounders found no significant difference between the two populations. The patients undergoing CABG surgery with COPD did experience significantly longer length of stay (6.7 ± 6.0 days vs. 5.9 ± 6.1 days, p < 0.05), more likely to significantly elevate their creatinine after surgery (OR 1.46, 95% CI 1.15 to 1.85), more prolonged ventilation (OR 1.99, 95% CI 1.60 to 2.49), more likely to get pneumonia (OR 2.99, 95% CI 2.25 to 3.96) and significantly more mortality (OR 1.78, (95% CI 1.32 to 2.40). Patients with COPD undergoing CABG surgery experience significantly more mortality and more morbidity compared to patients without COPD.