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Short-term and long-term impact of diagnosed and undiagnosed chronic obstructive pulmonary disease on coronary artery bypass grafting surgery
  1. Francesca Gatta1,
  2. Yama Haqzad1,
  3. Mahmoud Loubani2
  1. 1Department of Cardiothoracic Surgery, Castle Hill Hospital, Cottingham, UK
  2. 2Department of Cardiothoracic Surgery, Hull University Teaching Hospitals NHS Trust, Hull, UK
  1. Correspondence to Dr Francesca Gatta, Department of Cardiothoracic Surgery, Castle Hill Hospital, Cottingham HU16 5JQ, UK; francesca.gatta92{at}gmail.com

Abstract

Objectives This study sought to compare clinical outcomes between three categories of patients: non-chronic obstructive pulmonary disease (COPD), diagnosed COPD and undiagnosed COPD in coronary artery bypass grafting surgery.

Methods A single-centred retrospective study from January 2010 to December 2019. Primary outcomes were postoperative complications, length of ITU admission and in-hospital staying. Secondary outcomes were reintervention rate, in-hospital and long-term mortality.

Results A total of 4020 patients were analysed and divided into three cohorts: non-COPD (group A) (74.55%, n=2997), diagnosed COPD (group B) (14.78%, n=594) and undiagnosed COPD (group C) (10.67%, n=429). The rate of respiratory complications was noted in this order: group B>group C>group A (p 0.00000002). Periooperative acute kidney injury and wound complications were higher in group B (p 0.0004 and p 0.03, respectively). Prolonged in-hospital staying (days) resulted in group B (p 0.0009). Finally, long-term mortality was statistically higher in group B and C compared with group A (p 0.0004). No difference in long-term mortality was noted in relation to the expected FEV1% in group B (p 0.29) and group C (p 0.82).

Conclusions In CABG surgery, COPD is a well-known independent risk factor for morbidity. Patients with preoperative spirometry results indicative of COPD result in the same outcomes of known patients with COPD. As a result of that, greater value should be given to the preoperative spirometry in the EuroSCORE. Finally, the expected FEV1% appears not be a predictor for long-term survival.

  • coronary heart disease
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Footnotes

  • Contributors FG and YH: conception and design, data collection, statistical analysis and interpretation, and manuscript writing. ML: conception and design, data collection, statistical analysis and interpretation, manuscript writing and critical revision of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.

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