Abstract

The objective of this study was to assess if there are any differences between patients undergoing coronary artery bypass graft surgery with COPD compared to patients without COPD. We conducted a prospective hospitalization cohort study. The study population was patients undergoing CABG by the Cardiovascular Thoracic Surgery Group. Inclusion criteria included CABG surgery between 10/1/93 and 1/1/8 and age greater than eighteen. Exclusion criteria included any other surgery performed simultaneously with the CABG surgery, repeat procedures, and any patient with incomplete data for the COPD variable. Data were collected on 225 variables concurrently with admission. We controlled for seven variables. The primary outcome was thirty-day mortality. There were eight secondary outcomes. Ten thousand, four hundred and fourteen patients meet the criteria to be included in the cohort, (1,739 with COPD and a positive smoking history, 8,675 patients without COPD). Univariate analysis comparing the patients with and without COPD for the seven potential confounders found no significant difference between the two populations. The patients undergoing CABG surgery with COPD did experience significantly longer length of stay (6.7 ± 6.0 days vs. 5.9 ± 6.1 days, p < 0.05), more likely to significantly elevate their creatinine after surgery (OR 1.46, 95% CI 1.15 to 1.85), more prolonged ventilation (OR 1.99, 95% CI 1.60 to 2.49), more likely to get pneumonia (OR 2.99, 95% CI 2.25 to 3.96) and significantly more mortality (OR 1.78, (95% CI 1.32 to 2.40). Patients with COPD undergoing CABG surgery experience significantly more mortality and more morbidity compared to patients without COPD.

Key words: COPD, CABG.