TY - JOUR
T1 - National analysis of short-term outcomes after pulmonary resections on cardiopulmonary bypass
AU - De Biasi, Andreas R.
AU - Nasar, Abu
AU - Lee, Paul C.
AU - Port, Jeffrey L.
AU - Stiles, Brendon
AU - Salemi, Arash
AU - Girardi, Leonard
AU - Altorki, Nasser K.
AU - Paul, Subroto
N1 - Publisher Copyright:
© 2015 The Society of Thoracic Surgeons.
PY - 2015
Y1 - 2015
N2 - Background Pulmonary resections using cardiopulmonary bypass (CPB) are infrequently performed. Their short-term outcomes are not well described. We queried the National Inpatient Sample over a 10-year period (2001 to 2011) to more clearly delineate the short-term outcomes of patients undergoing pulmonary resections on CPB. Methods We identified all patients 18 years and older who underwent pulmonary lobectomy (LB) or pneumonectomy (PN) on CPB; lung transplantations were excluded. We then grouped these patients based on the setting in which bypass was used: LB/PN with planned CPB (group 1), LB/PN with concomitant on-pump cardiac procedure (group 2), or LB/PN requiring CPB secondary to injury (group 3). Demographic data and inhospital outcomes were obtained for each patient. Results In all, 843 patients underwent LB or PN on CPB during the study period. Lobectomies were the most commonly performed procedure overall. Inhospital mortality for groups 1, 2, and 3 were 22% (n = 58), 16% (n = 61), and 57% (n = 115), respectively. Complications were prevalent across all groups. Routine discharge was achieved by fewer than half of all patients: 48% of group 1 (n = 128); 34% of group 2 (n = 129); and 18% of group 3 (n = 36). Pneumonectomy (odds ratio 2.74, 95% confidence interval: 1.00 to 7.53, p = 0.049) as well as using CPB either as part of a combined cardiac surgery (odds ratio 1.48, 95% confidence interval: 0.39 to 5.59, p = 0.002) or because of injury (odds ratio 6.52, 95% confidence interval: 2.13 to 19.99, p = 0.002) were found to be significant multivariate predictors of short-term mortality. Conclusions Pulmonary resections on CPB carry considerable short-term mortality and morbidity, but some risk can be partially mitigated when bypass is planned preoperatively.
AB - Background Pulmonary resections using cardiopulmonary bypass (CPB) are infrequently performed. Their short-term outcomes are not well described. We queried the National Inpatient Sample over a 10-year period (2001 to 2011) to more clearly delineate the short-term outcomes of patients undergoing pulmonary resections on CPB. Methods We identified all patients 18 years and older who underwent pulmonary lobectomy (LB) or pneumonectomy (PN) on CPB; lung transplantations were excluded. We then grouped these patients based on the setting in which bypass was used: LB/PN with planned CPB (group 1), LB/PN with concomitant on-pump cardiac procedure (group 2), or LB/PN requiring CPB secondary to injury (group 3). Demographic data and inhospital outcomes were obtained for each patient. Results In all, 843 patients underwent LB or PN on CPB during the study period. Lobectomies were the most commonly performed procedure overall. Inhospital mortality for groups 1, 2, and 3 were 22% (n = 58), 16% (n = 61), and 57% (n = 115), respectively. Complications were prevalent across all groups. Routine discharge was achieved by fewer than half of all patients: 48% of group 1 (n = 128); 34% of group 2 (n = 129); and 18% of group 3 (n = 36). Pneumonectomy (odds ratio 2.74, 95% confidence interval: 1.00 to 7.53, p = 0.049) as well as using CPB either as part of a combined cardiac surgery (odds ratio 1.48, 95% confidence interval: 0.39 to 5.59, p = 0.002) or because of injury (odds ratio 6.52, 95% confidence interval: 2.13 to 19.99, p = 0.002) were found to be significant multivariate predictors of short-term mortality. Conclusions Pulmonary resections on CPB carry considerable short-term mortality and morbidity, but some risk can be partially mitigated when bypass is planned preoperatively.
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U2 - 10.1016/j.athoracsur.2015.05.085
DO - 10.1016/j.athoracsur.2015.05.085
M3 - Article
C2 - 26296268
AN - SCOPUS:84939826377
SN - 0003-4975
VL - 100
SP - 2064
EP - 2071
JO - Annals of Thoracic Surgery
JF - Annals of Thoracic Surgery
IS - 6
ER -