Pulmonary function and immediate and late outcome after coronary artery bypass surgery.
OBJECTIVE
The aim of this study was to evaluate whether pulmonary function as assessed by spirometry affects the immediate and late outcome after isolated coronary artery bypass surgery (CABG).


METHODS
Data on preoperative percentages of the predicted forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) were retrieved from a series of 1848 patients who underwent isolated CABG. Pulmonary disease was defined according to EuroSCORE criteria.


RESULTS
Logistic regression showed that percentage of predicted FVC was an independent predictor of in-hospital mortality along with estimated glomerular filtration rate, age and extracardiac arteriopathy. Cox regression analysis showed that pulmonary disease and percentages of predicted FVC were independent predictors of late overall mortality. Percentage of predicted FVC < 70% (at 10-year: 63.8% vs. 74.3%, Cox regression analysis: P = 0.014, RR 1.50, 95%C.I. 1.08-2.08) and pulmonary disease (at 10-year: 58.0% vs. 76%, Cox regression analysis: P < 0.0001, RR 1.75, 95%C.I. 1.29-2.39), but not percentage of predicted FEV1 < 70%, were associated with a marked decrease in late survival.


CONCLUSIONS
This study confirmed the significant, negative prognostic impact of pulmonary disease on the immediate and long-term survival after isolated CABG.
Department of Thoracic and Vascular Surgery, Vaasa Central Hospital, Vaasa, Finland. faustobiancari@yahoo.it
J
J
Nissinen
F
F
Biancari
J O
JO
Wistbacka
P
P
Loponen
P
P
Kairi
K
K
Korpilahti
M
M
Tarkka
D000367:Age Factors; D000368:Aged; D016009:Chi-Square Distribution; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000401:mortality; D019992:Databases as Topic; D005260:Female; D005387:Finland; D005541:Forced Expiratory Volume; D005919:Glomerular Filtration Rate; D017052:Hospital Mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008168:Lung / Q000503:physiopathology*; D008171:Lung Diseases / Q000150:complications* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012307:Risk Factors; D013147:Spirometry; D013997:Time Factors; D016896:Treatment Outcome; D014652:Vascular Diseases / Q000150:complications; D014797:Vital Capacity