Incidence and outcomes of pneumonia after isolated off-pump coronary artery bypass grafting.
BACKGROUND
Pneumonia is a major complication of cardiac surgery, with cardiopulmonary bypass considered one of the causes of pulmonary dysfunction. The incidence of pneumonia has decreased with improved surgical techniques and postoperative management; however, the incidence and outcome of pneumonia after off-pump coronary artery bypass grafting (OPCAB) are largely unknown.


METHODS
We retrospectively reviewed the records of 719 patients who underwent isolated OPCAB between September 2004 and June 2008. Pneumonia was confirmed with a chest radiograph or by computed tomography. We compared preoperative and postoperative variables for patients with and without pneumonia, and for patients with postoperative pneumonia who died from pneumonia and those who survived.


RESULTS
We identified 11 patients (1.5%) as having pneumonia after OPCAB. The most frequently observed organism in patients with postoperative pneumonia was Klebsiella. There were no significant differences between patients with pneumonia and those without pneumonia with respect to age (75.5 +/- 7.1 years versus 67.8 +/- 10.0 years; P = .0724), prior myocardial infarction (72.7% versus 47.5%; P = .0792), or postoperative intubation time (16.2 +/- 15.1 hours versus 10.2 +/- 16.0 hours; P = .2781). The operative mortality rate (within 30 days) was significantly higher in patients with pneumonia (36.4% versus 0%; P< .0001).


CONCLUSIONS
The incidence of pneumonia after OPCAB is low, although pneumonia remains one of most devastating complications after OPCAB.
Fukui
Toshihiro
T
Department of Cardiovascular Surgery, Sakakibara Heart Institute, 3-16-1 Asahi-cho, Fuchu, Tokyo, Japan. tfukui-cvs@umin.ac.jp
Manabe
Susumu
S
Shimokawa
Tomoki
T
Takanashi
Shuichiro
S
D000368:Aged; D015897:Comorbidity; D047549:Coronary Artery Bypass, Off-Pump / Q000401:mortality*; D005260:Female; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D011014:Pneumonia / Q000401:mortality*; D011183:Postoperative Complications / Q000401:mortality*; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome