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Influence of reduced diffusing capacity and FEV 1 on outcome after cardiac surgery
Author(s) -
Risom Emilie C.,
Buggeskov Katrine B.,
Petersen René H.,
Mortensen Jann,
Ravn Hanne B.
Publication year - 2021
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/aas.13935
Subject(s) - dlco , medicine , spirometry , diffusing capacity , cardiology , cardiac surgery , prospective cohort study , pulmonary function testing , intensive care unit , surgery , lung , lung function , asthma
Background Impaired lung function is a well‐known risk factor in cardiac surgery patients and reduced forced expiratory volume in 1 second (FEV 1 ) is associated with increased mortality. However, there is limited knowledge regarding the influence of impaired diffusing capacity of the lungs for carbon monoxide (DLCO) in unselected cardiac surgery patients. The aim of this study was to investigate the association of impaired DLCO and/or reduced FEV 1 on post‐operative mortality and morbidity in cardiac surgery patients. Methods In a prospective cohort study, 390 patients scheduled for elective cardiac surgery underwent preoperative lung function test including spirometry and DLCO measurements. We defined reduced FEV 1 as FEV 1 below lower limit of normal (LLN) and impaired DLCO as DLCO <60% of predicted. Results Mortality within 1 year (90‐570 days) was significantly higher in patients with impaired DLCO (12% vs 3%, P = .010) and with reduced FEV 1 (9% vs 3%, P = .028). Mortality was higher in patients with impaired DLCO both in the presence and absence of FEV 1 < LLN. In multivariate analysis, only impaired DLCO [OR: 3.3, 95% confidence interval (CI) 1.4‐7.5; P = .005] and age (OR: 1.1 per year, 95% CI 1.0‐1.2; P = .001) were independent predictors of the combined outcome of mortality and prolonged intensive care unit (ICU) stay. Impaired DLCO was also associated with post‐operative respiratory complications. Conclusion In patients undergoing elective cardiac surgery, preoperative impaired FEV 1 and DLCO were associated with increased mortality and morbidity. In multivariate analysis, only DLCO and age were independent predictors of a combined outcome of mortality and prolonged ICU stay.