Akciğer Rezeksiyonu Sonrasi Gelişen Kardiyak Komplikasyonlar İçin Risk Faktörlerinin Değerlendirilmesi

Amaç: Bu çalışmanın amacı hastanemizde yapılan akciğer rezeksiyonları sonrası hastalarda görülen kardiyak komplikasyonları(KK) araştırmaktır. 2017-2020 yılları arasında akciğer rezeksiyonu yapılan 1186 hastanın perioperatif verileri retrospektif olarak değerlendirildi. 136 hastada kardiyak komplikasyon gelişti. Bu komplikasyonlar ile hastaların perioperatif özellikleri arasındaki ilişki analiz edildi. Bulgular: 287 (%81.8) erkek ve 64 (%18.2) kadın vardı. Ortalama yaş 58.9 idi. Ameliyat sonrası kardiyak komplikasyonlar 65 yaş üstü (p = 0,001) ve erkek (p = 0,02) olan hastalarda anlamlı olarak daha sıktı; konjestif kalp yetmezliği (KKY) (p < 0,001), koroner arter hastalığı (KAH) (p = 0,003), hipertansiyon (HT) (p = 0,002), hiperlipidemi (HL) (p < 0,001), kronik obstrüktif akciğer hastalığı ( KOAH) (p < 0,001), tiroid hastalığı (p = 0,003), kronik böbrek yetmezliği (KBY) (p = 0,03), serebrovasküler olay (SVO) (p <0,001) veya aritmi (p < 0,001); akciğer kanseri nedeniyle ameliyat oldu (p = 0,008); neoadjuvan tedavi aldı (p < 0,001); ve ejeksiyon fraksiyonu (EF) < %60 (p < 0.001) vardı. Daha yüksek KK oranı ile ilişkili cerrahi faktörler, pnömonektomi (p < 0.001), torakotomi (p = 0.02) ve intraoperatif kan transfüzyonu (p < 0.001) veya inotrop (p < 0.001) almaktı. Çoklu lojistik regresyon analizi, ameliyat öncesi tiroid hastalığı (p = 0.04), CVA (p = 0.0001), neoadjuvan tedavi (p = 0.002), EF < %60 (p = 0.01), pnömonektomi (p = 0.003), intraoperatif kan transfüzyonu gösterdi. (p < 0.0001) ve yüksek SOFA skoru (p < 0.0001) PCC gelişimini etkileyen bağımsız risk faktörleriydi. Sonuç: Akciğer rezeksiyonu sonrası kardiyak komplikasyonlar erkek cinsiyet, HT, pnömonektomi, torakotomi, inotrop kullanımı ve neoadjuvan tedavi ile güçlü bir şekilde ilişkiliydi.

Anahtar Kelimeler:

VATS, Akciğer rezeksiyonu, Torakotomi, Kardiyak komplikasyon

Evaluation of Risk Factors for Cardiac Complications After Lung Resection

Abstract Background:The aim of this study was to investigate cardiac complications in patients following lung resections performed in our hospital. The perioperative data of 1186 patients who underwent lung resection between 2017 and 2020 were evaluated retrospectively. Cardiac complications occurred in 136 patients. The relationship between these complications and the patients’ perioperative characteristics was analyzed. Results:There were 287 (81.8%) men and 64 (18.2%) women. The mean age was 58.9 years. Postoperative cardiac complications were significantly more frequent among patients who were older than 65 years (p = 0.001) and male (p = 0.02); had congestive heart failure (CHF) (p < 0.001), coronary artery disease (CAD) (p = 0.003), hypertension (HT) (p = 0.002), hyperlipidemia (HL) (p < 0.001), chronic obstructive pulmonary disease (COPD) (p < 0.001), thyroid disease (p = 0.003), chronic renal failure (CRF) (p = 0.03), cerebrovascular accident (CVA) (p <0.001), or arrhythmia (p < 0.001); underwent surgery due to lung cancer (p = 0.008); received neoadjuvant therapy (p < 0.001); and had ejection fraction (EF) < 60% (p < 0.001). Surgical factors associated with higher rate of PCC were undergoing pneumonectomy (p < 0.001), thoracotomy (p = 0.02), and receiving intraoperative blood transfusion (p < 0.001) or inotropes (p < 0.001). Multiple logistic regression analysis showed that preoperative thyroid disease (p = 0.04), CVA (p = 0.0001), neoadjuvant therapy (p = 0.002), EF < 60% (p = 0.01), pneumonectomy (p = 0.003), intraoperative blood transfusion (p < 0.0001), and high SOFA score (p < 0.0001) were independent risk factors affecting PCC development. Conclusion:Cardiac complications after lung resection were strongly associated with male sex, HT, pneumonectomy, thoracotomy, inotrope use, and neoadjuvant therapy. Keywords: Lung resection, Cardiac complications, Atrial fibrillation, Thoracotomy, Video-assisted thoracoscopic surgery

Keywords:

lung resection, Cardiac complication, VATS, Thoracotomy,

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