Abstract | BACKGROUND: Postoperative major pulmonary complications (MPCs) continue to be leading causes of increased morbidity and death after cardiac surgery. Although various risk factors have been identified, reports on the association between sleep-disordered breathing (SDB) and postoperative MPCs remain inconclusive. RESEARCH QUESTION: What is the incidence of the composite end point postoperative MPCs? What are predictors for postoperative MPCs in patients without SDB, with OSA, and with central sleep apnea (CSA) who undergo cardiac surgery? STUDY DESIGN AND METHODS: RESULTS: Patients with SDB experienced significantly more often postoperative MPCs than patients without SDB (24% vs 7%; P < .001). Multivariable logistic regression analysis showed that CSA (OR, 4.68 [95% CI, 1.78-12.26]; P = .002), heart failure (OR, 2.65 [95% CI, 1.11-6.31]; P = .028), and a history of transient ischemic attack or stroke (OR, 2.73 [95% CI, 1.07-6.94]; P = .035) were associated significantly with postoperative MPCs. Compared with patients without MPCs, those with postoperative MPCs had a significantly longer hospital stay (median days, 9 [25th/75th percentile, 7/13] vs 19 [25th/75th percentile, 11/38]; P < .001). INTERPRETATION: Among established risk factors for postoperative MPCs, CSA, heart failure, and history of transient ischemic attack or stroke were associated significantly with postoperative MPCs. Our findings contribute to the identification of patients who are at high-risk for postoperative MPCs. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov identifier NCT02877745.
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Authors | Maria Tafelmeier, Lili Luft, Elisabeth Zistler, Bernhard Floerchinger, Daniele Camboni, Marcus Creutzenberg, Florian Zeman, Christof Schmid, Lars Siegfried Maier, Stefan Wagner, Michael Arzt |
Journal | Chest
(Chest)
Vol. 159
Issue 2
Pg. 798-809
(02 2021)
ISSN: 1931-3543 [Electronic] United States |
PMID | 32798522
(Publication Type: Journal Article, Observational Study)
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Copyright | Copyright © 2020 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved. |
Topics |
- Aged
- Cardiac Surgical Procedures
- Female
- Humans
- Lung Diseases
(etiology)
- Male
- Postoperative Complications
(etiology)
- Prospective Studies
- Risk Factors
- Sleep Apnea, Central
(complications)
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