0
Original Research |

Predictors and Early and Late Outcomes of Respiratory Failure in Contemporary Cardiac Surgery*

Farzan Filsoufi, MD; Parwis B. Rahmanian, MD; Javier G. Castillo, MD; Joanna Chikwe, MD; David H. Adams, MD
Author and Funding Information

*From the Department of Cardiothoracic Surgery, Mount Sinai School of Medicine, New York, NY.

Correspondence to: Farzan Filsoufi, MD, Associate Professor, Associate Chief Cardiac Surgery, Mount Sinai School of Medicine, 1190 Fifth Ave, New York, NY 10029-1028; e-mail: farzan.filsoufi@mountsinai.org


Chest. 2008;133(3):713-721. doi:10.1378/chest.07-1028
Text Size: A A A
Published online

Background: Respiratory failure (RF) is a serious complication following heart surgery. The profile of patients referred for cardiac surgery has changed during the last decade, making prior investigations of RF after cardiac surgery less relevant to the current population. This study was designed to analyze the incidence, predictors of RF, and early and late outcomes following this complication in a large contemporary cardiac surgery population.

Methods: We retrospectively analyzed prospectively collected data from the New York State Department of Health database including 5,798 patients undergoing cardiac surgery between January 1998 and December 2005. Patients with RF (intubation time ≥ 72 h) were compared to patients without RF.

Results: The incidence of RF was 9.1% (n = 529). The highest incidence of RF was observed following combined valve/coronary artery bypass graft (14.8%) and aortic procedures (13.5%). Multivariate analysis revealed preoperative and operative predictors of RF such as renal failure (odds ratio [OR], 2.3), aortic procedures (OR, 2.6), hemodynamic instability (OR, 3.2), and intraaortic balloon pump (OR, 2.6). The mortality rate following RF was 15.5% (n = 82), compared to 2.4% (n = 126) in the no-RF group (p < 0.001). Kaplan-Meier survival curves showed significantly poorer survival among RF patients (p < 0.001) compared to the no-RF group.

Conclusion: RF remains a serious and common complication following cardiac surgery, particularly in patients undergoing complex procedures. RF is associated with significant comorbidity, increased hospital mortality, and reduced long-term survival. Future research efforts should focus on a more precise identification of patients at risk and the development of new treatment modalities that would potentially prevent the occurrence of this complication.

Figures in this Article

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
Intraoperative Interventions*: American College of Chest Physicians Guidelines for the Prevention and Management of Postoperative Atrial Fibrillation After Cardiac Surgery
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543