To determine the different factors predicting pleural effusion after open heart surgery and to determine the overall incidence of pleural effusion after open heart surgery.
127 consecutive patients who had open heart surgery were analyzed. Baseline chest radiographs and laboratories were taken. They were observed for development of pleural effusion. Chest radiographs were repeated immediately post operatively, after 7 days and 8–14 days after open heart surgery. Different factors were identified and analyzed in relation to development of pleural effusion.
Demography such as age (p = 0.099) and gender (male)(p = 0.053) may show a trend towards possible risk of pleural effusion. History of > 10 pack year of smoking (p = 0.007)predicted pleural effusion. Presence of co-morbidities, Hypertension, (p = 0.013) Diabetes mellitus (p = 0.050) and Nephropathy (p = 0.015) increases the risk for pleural effusion.The longer the cardiopulmonary bypass time (p = 0.008) and ischemic time (p = 0.001))increases the risk of pleural effusion.The use of sephenous venous graft in combination with left internal mammary artery (p = 0.004) showed a significant difference in predicting occurrence of effusion.Preoperative creatinine, pre operative and post operative creatinine and post operative P/F ratio can predict those patients at risk for pleural effusion. The overall incidence of pleural effusion 7 days after open heart surgery was 25.3 % and after 14 days its 47.2%.
We identified the different factors which could predict the occurrence of pleural effusion after open heart surgery. Smoking history > 10 pack years (p = 0.007), presence of co morbidities such as hypertension (p = 0.013), diabetes mellitus (p = 0.050) and nephropathy (p = 0.015) increases risk for pleural effusion. Laboratory variables such as creatinine, albumin and P/F ratio were found to predic pleural effusion after open heart surgery.Intra operative factors such as prolonged bypass and ischemic time, the use of sephenous venous graft in combination with left internal mammary artery increases the risk for effusion.
Identifying these factors and determinants associated with post operative pleural effusion may result in earlier recognition of patients at risk and facilitate preemptive clinical practice through proper referrals and management.
Jerome Santos, No Financial Disclosure Information; No Product/Research Disclosure Information