The Role of Preoperative Chronic Obstructive Pulmonary Disease to Predict Morbidity after Coronary Artery Bypass Surgery
Seyed Yaser Hariri1, Adel Johari Moghadam2 and Reza Arefizadeh2*1Khatamolanbia Air Defence Medical University, Tehran, Iran.
2Department of Cardiology, AJA University of Medical Sciences, Tehran, Iran.
*Corresponding Author E-mail : arefizadehreza@yahoo.com
Abstract: Prevalence of chronic obstructive pulmonary disease (COPD) among patients who are candidates for cardiac surgeries has a wide spectrum. Therefore, assessment of the prognostic value of preoperative COPD in different population is necessary. The present study assessed the role of different severities of COPD for prediction of morbidity in patients undergoing coronary artery bypass grafting (CABG).Five hundred and seventy consecutive patients underwent pure CABG were studied. Patients were divided into three groups depending on the spirometry as control (FEV1 80% or more, FEV1/ FVC> 0.7), mild to moderate COPD (FEV1 50% or more and FEV1/FVC 0.7 or less) and severe COPD (FEV1 less than 50% and FEV1/FVC 0.7 or less). Preoperative pulmonary function indices were assessed as predictors and postoperative morbidity was used as surgical outcome.Studied groups were similar with regard to coronary artery disease risk factors, except for hypertension and recent myocardial infarction that were more frequent in patients with severe COPD. Mean of body mass index in the group with severe COPD was significantly lower than the control group, however this parameter was comparable in control group and the group with mild to moderate COPD. Multivariate logistic regression analysis showed that preoperative FVC measure predicted post-CABG morbidity with the presence of confounders (OR: 0.989, 95% CI: 0.979 – 1.000, p=0.046).Among preoperative pulmonary function indices, FVC can effectively predict in-hospital morbidity after CABG.
Keywords: Chronic Obstructive Pulmonary Disease; Coronary Artery Bypass Grafting; Spirometry Back to TOC