Postoperative Complications After Coronary Artery Bypass Grafting in Patients With Chronic Obstructive Pulmonary Disease

doi:10.1097/MD.0000000000002926

CNU IR > College of Recreation and Health Management > Dept. of Recreation and Health-Care Management > Periodical Articles > Item 310902800/31083

Please use this identifier to cite or link to this item: http://ir.cnu.edu.tw/handle/310902800/31083

Title:	Postoperative Complications After Coronary Artery Bypass Grafting in Patients With Chronic Obstructive Pulmonary Disease
Authors:	Ho, Chung-Han Chen, Yi-Chen Chu, Chin-Chen Wang, Jhi-Joung Liao, Kuang-Ming
Contributors:	Chia Nan Univ Pharm & Sci, Chi Mei Med Ctr, Dept Med Res Chia Nan Univ Pharm & Sci, Dept Hosp & Hlth Care Adm Chia Nan Univ Pharm & Sci, Chi Mei Med Ctr, Dept Anesthesiol Chia Nan Univ Pharm & Sci, Dept Recreat & Health Care Management Chi Mei Med Ctr, Dept Internal Med
Keywords:	deep-vein thrombosis preoperative prediction risk copd term stratification morbidity mortality severity surgery
Date:	2016-02
Issue Date:	2018-01-18 11:41:24 (UTC+8)
Publisher:	Lippincott Williams & Wilkins
Abstract:	Coronary artery disease is common in patients with chronic obstructive pulmonary disease (COPD). Previous studies have shown that patients with COPD have a higher risk of mortality than those without COPD after coronary artery bypass grafting (CABG). However, most of the previous studies were small, single-center studies with limited case numbers (or their only focus was mortality). The aim of our study was to focus on readmission, acute myocardial infarction (AMI), acute respiratory failure (ARF), cerebrovascular accident, and venous thromboembolism rates after CABG in an Asian COPD population.We conducted a nationwide case-control study in Taiwan using the claims database of hospitalization between January 1, 2009 and December 31, 2013. Patients with COPD before CABG were defined as the case groups. Each case was propensity score-matched by age, sex, hypertension, diabetes, dyslipidemia, cardiovascular disease, cerebrovascular disease, and chronic kidney disease, with 2 controls selected from CABG patients without COPD. The outcomes of interest were mortality, wound infection, and the readmission rate over 30 days for the following diseases: AMI, pneumonia, ARF, cerebrovascular accident, and venous thromboembolism.There were 14,858 patients without COPD and 758 patients with COPD who underwent CABG. After propensity score matching, the 30-day mortality and 30-day readmission rates and AMI were higher in the non-COPD group. The incidences of pneumonia and ARF after CABG were higher in the COPD group.Chronic obstructive pulmonary disease does not necessarily lead to mortality, readmission, or AMI after CABG, and the major respiratory complications associated with CABG in patients with COPD were pneumonia and ARF.
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