Preoperative pulmonary function and mortality after cardiac surgery
Background The aim of the study was to examine the relationship between preoperative pulmonary function and outcomes after cardiac surgery. Methods We performed preoperative pulmonary function tests (PFTs) in 1,169 patients undergoing cardiac surgery at the Minneapolis Veterans Affairs Medical Cente...
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| Veröffentlicht in: | The American heart journal 2010-04, Vol.159 (4), p.691-697 |
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| creator | Adabag, A. Selcuk, MD, MS Wassif, Heba S., MD, MPH Rice, Kathryn, MD Mithani, Salima, MD Johnson, Deborah, RN Bonawitz-Conlin, Jana, BSN, MSH Ward, Herbert B., MD, PhD McFalls, Edward O., MD, PhD Kuskowski, Michael A., PhD Kelly, Rosemary F., MD |
| description | Background The aim of the study was to examine the relationship between preoperative pulmonary function and outcomes after cardiac surgery. Methods We performed preoperative pulmonary function tests (PFTs) in 1,169 patients undergoing cardiac surgery at the Minneapolis Veterans Affairs Medical Center. Airway obstruction was defined as forced expiratory volume in 1 minute (FEV1 ) to forced vital capacity ratio |
| doi_str_mv | 10.1016/j.ahj.2009.12.039 |
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Selcuk, MD, MS ; Wassif, Heba S., MD, MPH ; Rice, Kathryn, MD ; Mithani, Salima, MD ; Johnson, Deborah, RN ; Bonawitz-Conlin, Jana, BSN, MSH ; Ward, Herbert B., MD, PhD ; McFalls, Edward O., MD, PhD ; Kuskowski, Michael A., PhD ; Kelly, Rosemary F., MD</creator><creatorcontrib>Adabag, A. Selcuk, MD, MS ; Wassif, Heba S., MD, MPH ; Rice, Kathryn, MD ; Mithani, Salima, MD ; Johnson, Deborah, RN ; Bonawitz-Conlin, Jana, BSN, MSH ; Ward, Herbert B., MD, PhD ; McFalls, Edward O., MD, PhD ; Kuskowski, Michael A., PhD ; Kelly, Rosemary F., MD</creatorcontrib><description>Background The aim of the study was to examine the relationship between preoperative pulmonary function and outcomes after cardiac surgery. Methods We performed preoperative pulmonary function tests (PFTs) in 1,169 patients undergoing cardiac surgery at the Minneapolis Veterans Affairs Medical Center. Airway obstruction was defined as forced expiratory volume in 1 minute (FEV1 ) to forced vital capacity ratio <0.7. Results Of the 1,169 patients, 483 (41%) had a prior history of chronic obstructive pulmonary disease (COPD). However, 178 patients with a history of COPD had no airway obstruction on PFT. Conversely, 186 patients without a COPD history had airway obstruction on PFT. Thus, PFT results helped reclassify the COPD status of 364 patients (31%). Operative mortality was 2% in patients with no or mild airway obstruction versus 6.7% in those with moderate or severe obstruction (ie, FEV1 to forced vital capacity ratio <0.7 and FEV1 <80% predicted). Postoperative mortality was higher (odds ratio 3.2, 95% CI 1.6-6.2, P = .001) in patients with moderate or severe airway obstruction and in patients with diffusing capacity of the lung for carbon monoxide <50% of predicted (odds ratio 4.9, 95% CI 2.3-10.8, P = .0001). Notably, mortality risk was 10× higher (95% CI 3.4-27.2, P = .0001) in patients with moderate or severe airway obstruction and diffusing capacity of the lung for carbon monoxide <50% of predicted. Conclusions These data show that PFT before cardiac surgery reclassifies the COPD status of a substantial number of patients and provides important prognostic information that the current risk estimate models do not capture.</description><identifier>ISSN: 0002-8703</identifier><identifier>EISSN: 1097-6744</identifier><identifier>DOI: 10.1016/j.ahj.2009.12.039</identifier><identifier>PMID: 20362731</identifier><identifier>CODEN: AHJOA2</identifier><language>eng</language><publisher>United States: Mosby, Inc</publisher><subject>Aged ; Airway management ; Cardiovascular ; Chronic obstructive pulmonary disease ; Female ; Forced Expiratory Volume ; Heart ; Heart attacks ; Heart Diseases - physiopathology ; Heart Diseases - surgery ; Heart surgery ; Hospitals ; Humans ; Male ; Middle Aged ; Mortality ; Patients ; Postoperative Complications ; Pulmonary Disease, Chronic Obstructive - diagnosis ; Pulmonary Disease, Chronic Obstructive - mortality ; Pulmonary Disease, Chronic Obstructive - physiopathology ; Risk Factors ; Studies ; Variables ; Ventilation ; Veterans ; Vital Capacity</subject><ispartof>The American heart journal, 2010-04, Vol.159 (4), p.691-697</ispartof><rights>2010</rights><rights>Published by Mosby, Inc.</rights><rights>Copyright Elsevier Limited Apr 2010</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c435t-89a06df5eae28898c07ed464072e55f3c37f8e2859747f36131a55d5b17271273</citedby><cites>FETCH-LOGICAL-c435t-89a06df5eae28898c07ed464072e55f3c37f8e2859747f36131a55d5b17271273</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0002870310000852$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20362731$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Adabag, A. Selcuk, MD, MS</creatorcontrib><creatorcontrib>Wassif, Heba S., MD, MPH</creatorcontrib><creatorcontrib>Rice, Kathryn, MD</creatorcontrib><creatorcontrib>Mithani, Salima, MD</creatorcontrib><creatorcontrib>Johnson, Deborah, RN</creatorcontrib><creatorcontrib>Bonawitz-Conlin, Jana, BSN, MSH</creatorcontrib><creatorcontrib>Ward, Herbert B., MD, PhD</creatorcontrib><creatorcontrib>McFalls, Edward O., MD, PhD</creatorcontrib><creatorcontrib>Kuskowski, Michael A., PhD</creatorcontrib><creatorcontrib>Kelly, Rosemary F., MD</creatorcontrib><title>Preoperative pulmonary function and mortality after cardiac surgery</title><title>The American heart journal</title><addtitle>Am Heart J</addtitle><description>Background The aim of the study was to examine the relationship between preoperative pulmonary function and outcomes after cardiac surgery. Methods We performed preoperative pulmonary function tests (PFTs) in 1,169 patients undergoing cardiac surgery at the Minneapolis Veterans Affairs Medical Center. Airway obstruction was defined as forced expiratory volume in 1 minute (FEV1 ) to forced vital capacity ratio <0.7. Results Of the 1,169 patients, 483 (41%) had a prior history of chronic obstructive pulmonary disease (COPD). However, 178 patients with a history of COPD had no airway obstruction on PFT. Conversely, 186 patients without a COPD history had airway obstruction on PFT. Thus, PFT results helped reclassify the COPD status of 364 patients (31%). Operative mortality was 2% in patients with no or mild airway obstruction versus 6.7% in those with moderate or severe obstruction (ie, FEV1 to forced vital capacity ratio <0.7 and FEV1 <80% predicted). Postoperative mortality was higher (odds ratio 3.2, 95% CI 1.6-6.2, P = .001) in patients with moderate or severe airway obstruction and in patients with diffusing capacity of the lung for carbon monoxide <50% of predicted (odds ratio 4.9, 95% CI 2.3-10.8, P = .0001). Notably, mortality risk was 10× higher (95% CI 3.4-27.2, P = .0001) in patients with moderate or severe airway obstruction and diffusing capacity of the lung for carbon monoxide <50% of predicted. Conclusions These data show that PFT before cardiac surgery reclassifies the COPD status of a substantial number of patients and provides important prognostic information that the current risk estimate models do not capture.</description><subject>Aged</subject><subject>Airway management</subject><subject>Cardiovascular</subject><subject>Chronic obstructive pulmonary disease</subject><subject>Female</subject><subject>Forced Expiratory Volume</subject><subject>Heart</subject><subject>Heart attacks</subject><subject>Heart Diseases - physiopathology</subject><subject>Heart Diseases - surgery</subject><subject>Heart surgery</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Patients</subject><subject>Postoperative Complications</subject><subject>Pulmonary Disease, Chronic Obstructive - diagnosis</subject><subject>Pulmonary Disease, Chronic Obstructive - mortality</subject><subject>Pulmonary Disease, Chronic Obstructive - physiopathology</subject><subject>Risk Factors</subject><subject>Studies</subject><subject>Variables</subject><subject>Ventilation</subject><subject>Veterans</subject><subject>Vital Capacity</subject><issn>0002-8703</issn><issn>1097-6744</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kU1r3DAQhkVpaLZpf0AvwdBDT3Zm9GHZFApl6RcEEkh7Foo8buXY1layA_vvo2XTFnLoSRJ63mHmGcbeIFQIWF8Mlf01VBygrZBXINpnbIPQ6rLWUj5nGwDgZaNBnLKXKQ35WfOmfsFOOYiaa4Ebtr2OFHYU7eLvqdit4xRmG_dFv85u8WEu7NwVU4iLHf2yL2y_UCycjZ23rkhr_Elx_4qd9HZM9PrxPGM_Pn_6vv1aXl59-bb9eFk6KdRSNq2FuusVWeJN0zYONHWylqA5KdULJ3Tf5C_Vaql7UaNAq1SnblFzjbndM_buWHcXw--V0mImnxyNo50prMloIRRKgW0m3z4hh7DGOTdnUIFUSknATOGRcjGkFKk3u-inPL1BMAfBZjBZsDkINshNFpwz54-V19uJur-JP0Yz8P4IUDZx7yma5DzNjjofyS2mC_6_5T88SbvRz97Z8Y72lP5NYVIOmJvDhg8LxnyBRnHxAET2nmg</recordid><startdate>20100401</startdate><enddate>20100401</enddate><creator>Adabag, A. Selcuk, MD, MS</creator><creator>Wassif, Heba S., MD, MPH</creator><creator>Rice, Kathryn, MD</creator><creator>Mithani, Salima, MD</creator><creator>Johnson, Deborah, RN</creator><creator>Bonawitz-Conlin, Jana, BSN, MSH</creator><creator>Ward, Herbert B., MD, PhD</creator><creator>McFalls, Edward O., MD, PhD</creator><creator>Kuskowski, Michael A., PhD</creator><creator>Kelly, Rosemary F., MD</creator><general>Mosby, Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20100401</creationdate><title>Preoperative pulmonary function and mortality after cardiac surgery</title><author>Adabag, A. Selcuk, MD, MS ; Wassif, Heba S., MD, MPH ; Rice, Kathryn, MD ; Mithani, Salima, MD ; Johnson, Deborah, RN ; Bonawitz-Conlin, Jana, BSN, MSH ; Ward, Herbert B., MD, PhD ; McFalls, Edward O., MD, PhD ; Kuskowski, Michael A., PhD ; Kelly, Rosemary F., MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c435t-89a06df5eae28898c07ed464072e55f3c37f8e2859747f36131a55d5b17271273</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Aged</topic><topic>Airway management</topic><topic>Cardiovascular</topic><topic>Chronic obstructive pulmonary disease</topic><topic>Female</topic><topic>Forced Expiratory Volume</topic><topic>Heart</topic><topic>Heart attacks</topic><topic>Heart Diseases - physiopathology</topic><topic>Heart Diseases - surgery</topic><topic>Heart surgery</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Patients</topic><topic>Postoperative Complications</topic><topic>Pulmonary Disease, Chronic Obstructive - diagnosis</topic><topic>Pulmonary Disease, Chronic Obstructive - mortality</topic><topic>Pulmonary Disease, Chronic Obstructive - physiopathology</topic><topic>Risk Factors</topic><topic>Studies</topic><topic>Variables</topic><topic>Ventilation</topic><topic>Veterans</topic><topic>Vital Capacity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Adabag, A. Selcuk, MD, MS</creatorcontrib><creatorcontrib>Wassif, Heba S., MD, MPH</creatorcontrib><creatorcontrib>Rice, Kathryn, MD</creatorcontrib><creatorcontrib>Mithani, Salima, MD</creatorcontrib><creatorcontrib>Johnson, Deborah, RN</creatorcontrib><creatorcontrib>Bonawitz-Conlin, Jana, BSN, MSH</creatorcontrib><creatorcontrib>Ward, Herbert B., MD, PhD</creatorcontrib><creatorcontrib>McFalls, Edward O., MD, PhD</creatorcontrib><creatorcontrib>Kuskowski, Michael A., PhD</creatorcontrib><creatorcontrib>Kelly, Rosemary F., MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Adabag, A. Selcuk, MD, MS</au><au>Wassif, Heba S., MD, MPH</au><au>Rice, Kathryn, MD</au><au>Mithani, Salima, MD</au><au>Johnson, Deborah, RN</au><au>Bonawitz-Conlin, Jana, BSN, MSH</au><au>Ward, Herbert B., MD, PhD</au><au>McFalls, Edward O., MD, PhD</au><au>Kuskowski, Michael A., PhD</au><au>Kelly, Rosemary F., MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Preoperative pulmonary function and mortality after cardiac surgery</atitle><jtitle>The American heart journal</jtitle><addtitle>Am Heart J</addtitle><date>2010-04-01</date><risdate>2010</risdate><volume>159</volume><issue>4</issue><spage>691</spage><epage>697</epage><pages>691-697</pages><issn>0002-8703</issn><eissn>1097-6744</eissn><coden>AHJOA2</coden><abstract>Background The aim of the study was to examine the relationship between preoperative pulmonary function and outcomes after cardiac surgery. Methods We performed preoperative pulmonary function tests (PFTs) in 1,169 patients undergoing cardiac surgery at the Minneapolis Veterans Affairs Medical Center. Airway obstruction was defined as forced expiratory volume in 1 minute (FEV1 ) to forced vital capacity ratio <0.7. Results Of the 1,169 patients, 483 (41%) had a prior history of chronic obstructive pulmonary disease (COPD). However, 178 patients with a history of COPD had no airway obstruction on PFT. Conversely, 186 patients without a COPD history had airway obstruction on PFT. Thus, PFT results helped reclassify the COPD status of 364 patients (31%). Operative mortality was 2% in patients with no or mild airway obstruction versus 6.7% in those with moderate or severe obstruction (ie, FEV1 to forced vital capacity ratio <0.7 and FEV1 <80% predicted). Postoperative mortality was higher (odds ratio 3.2, 95% CI 1.6-6.2, P = .001) in patients with moderate or severe airway obstruction and in patients with diffusing capacity of the lung for carbon monoxide <50% of predicted (odds ratio 4.9, 95% CI 2.3-10.8, P = .0001). Notably, mortality risk was 10× higher (95% CI 3.4-27.2, P = .0001) in patients with moderate or severe airway obstruction and diffusing capacity of the lung for carbon monoxide <50% of predicted. Conclusions These data show that PFT before cardiac surgery reclassifies the COPD status of a substantial number of patients and provides important prognostic information that the current risk estimate models do not capture.</abstract><cop>United States</cop><pub>Mosby, Inc</pub><pmid>20362731</pmid><doi>10.1016/j.ahj.2009.12.039</doi><tpages>7</tpages></addata></record> |
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| subjects | Aged Airway management Cardiovascular Chronic obstructive pulmonary disease Female Forced Expiratory Volume Heart Heart attacks Heart Diseases - physiopathology Heart Diseases - surgery Heart surgery Hospitals Humans Male Middle Aged Mortality Patients Postoperative Complications Pulmonary Disease, Chronic Obstructive - diagnosis Pulmonary Disease, Chronic Obstructive - mortality Pulmonary Disease, Chronic Obstructive - physiopathology Risk Factors Studies Variables Ventilation Veterans Vital Capacity |
| title | Preoperative pulmonary function and mortality after cardiac surgery |
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