Risk Factors for Pulmonary Complications in Patients With Cardiac Surgery in a Tertiary Heart Center

Postoperative pulmonary complications (PPCs) are among the leading causes of morbidity, mortality, and increased length of stay (LOS).

In a prospective cohort study, all adult candidates for all types of open-heart surgeries were enrolled and followed from admission to discharge for PPCs.

The study population consisted of 918 consecutive adult patients, including 574 (62.5%) males, at a mean age of 56.20±13.95 (mean ± standard deviation) years who underwent open cardiac surgery. Among them, 537 patients (58.5%) suffered PPCs, comprising pleural effusion in 293/916 (32.0%), atelectasis in 222 (24.2%), pneumonia in 68 (7.4%), diaphragm paralysis in 67 (7.3%), pulmonary edema and/or acute respiratory distress syndrome in 64/915 (7.0%), pneumothorax (in the right or left hemithorax) in 28/916 (3.1%), hemothorax in 7/915 (0.8%), subcutaneous emphysema in 11/913 (1.2%), and empyema in 2/918 (0.2) The independent risk factors for PPCs were age (OR, 1.010; 95% CI, 1.001 to 1.020; P=0.0326), female sex (OR, 1.375; 95% CI, 1.044 to 1.811; P=0.0235), and renal dysfunction (OR, 1.553; 95% CI, 1.001 to 2.409; P=0.0497). Twenty-three patients died within 30 days of cardiac surgery, accounting for a hospital mortality rate of 2.5%.

The cumulative incidence rate of PPCs was 58.5% in our center, with a mortality rate of 3.4%. The overall mortality rate among all the patients was 2.5%. The independent risk factors associated with PPCs were age, female sex, and renal failure.