Objective To investigate the risk factors of postoperative pulmonary complications of cardiac surgery.
Methods The medical records of patients who underwent cardiac surgery from January 2017 to December 2020 were retrospectively analyzed, while all patients were followed up for occurrence of pulmonary complications after surgery, who were divided into complication group (n = 271) and non-complication group (n = 331). Clinical variables including gender, age, ASA physical status, hypertension history, diabetes history, chronic obstructive pulmonary disease history, cerebrovascular disease history, operation history, preoperative atrial fibrillation, pulmonary hypertension, cardiac function, coagulation function, liver and kidney function, lactate dehydrogenase, blood glucose, operation time, cardiopulmonary bypass time, intraoperative drug use, intraoperative blood transfusion, intraoperative fluid transfusion, intraoperative urine volume, postoperative liver and kidney function, ECG were collected and their correlation with postoperative pulmonary complications were analyzed. Logistic regression was used to screen clinical indicators.
Results Compared with the non-complication group, the patients in the complication group were significantly older, and had a higher value of ASA physical status, preoperative atrial fibrillation and diabetes proportion, left atrial diameter, pulmonary hypertension, lymphocyte, globulin, total protein, lactate dehydrogenase, aspartate aminotransferase, urea nitrogen, operation time, cardiopulmonary bypass time, platelet transfusion, crystalloid fluid volume, postoperative urea nitrogen, postoperative creatinine, and drainage volume (P < 0.05). Multivariate logistic regression analysis suggested that preoperative atrial fibrillation (OR = 1.526, 95% CI 1.031-2.257, P = 0.034), ASA physical status Ⅳ (OR = 1.886, 95% CI 1.030-3.456, P = 0.040), cardiopulmonary bypass duration (OR = 2.418, 95% CI 1.692-3.456, P < 0.001) were independent risk factors.
Conclusion Preoperative atrial fibrillation, ASA physical status Ⅳ, cardiopulmonary bypass duration are independent risk factors of postoperative pulmonary complications of cardiac surgery. |
