Respiratory and clinical outcomes after coronary artery bypass surgery in male patients below and over 70 years of age
Amaç: Geriye yönelik olarak planlanan bu çalışmada 70 yaş altı ve üstü erkek hastalarda koroner arter bypass cerrahisi (KABC) sonrası solunum fonksiyonları ve klinik sonuçları değerlendirildi.Çalışma planı: Ocak 2002-Eylül 2006 tarihleri arasında KABC uygulanan 918 hastanın dosyası incelendi. Çalışmaya alınma kriterlerine yönelik hiçbir eksik bilgisi olmayan 112 erkek hasta 70 yaş altı veya üstü olarak iki gruba ayrıldı (genç grup: 89 hasta; ort. yaş 57.9±5.3 yıl; yaşlı grup: 23 hasta; ort. yaş 71.6±2.3) ve çalışmaya alındı. Her iki grubun ameliyat öncesi ve sonrası solunum fonksiyonları, solunum kas kuvveti ve klinik sonuçları karşılaştırıldı ve parametreler aralarındaki ilişki araştırıldı.Bulgular: Ameliyat öncesi vital kapasite (VC; p=0.0006), zorlu vital kapasite (FVC; p=0.0005), 1. sn’deki zorlu ekspiratuvar volüm (FEV1; p
Yetmiş yaş altı ve üstü erkek hastalarda koroner arter bypass cerrahisinden sonra solunumsal ve klinik sonuçlar
Background: This retrospective study was planned to evaluate respiratory functions and clinical outcomes in male patients below and over 70 years of age after coronary artery bypass surgery (CABS).Methods: Medical charts of 918 patients who underwent CABS between January 2002 and September 2006 were investigated and 112 male patients with no missing data according to the inclusion criteria were recruited for the study, and they were divided into two groups according to their ages being below or over 70 years (younger group: 89 patients; mean age 57.6±5.3 years and elderly group: 23 patients; mean age 71.6±2.3). Pre- and postoperative respiratory function, respiratory muscle strength and clinical outcomes of both groups were compared, and correlations between these parameters were investigated.Results: Before the surgery, vital capacity (VC; p=0.0006), forced vital capacity (FVC; p=0.0005), forced expiratory volume in 1 second (FEV1; p
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- 1) Acinapura AJ, Jacobowitz IJ, Kramer MD, Adkins MS, Zisbrod Z, Cunningham JN Jr. Demographic changes in coronary artery bypass surgery and its effect on mortality and morbidity. Eur J Cardiothorac Surg 1990;4:175-81.
- 2) Mohan R, Amsel BJ, Walter PJ. Coronary artery bypass grafting in the elderly-a review of studies on patients older than 64, 69 or 74 years. Cardiology 1992;80:215-25.
- 3) Fernandez J, Chen C, Anolik G, Brdlik OB, Laub GW, Anderson WA, et al. Perioperative risk factors affecting hospital stay and hospital costs in open heart surgery for patients > or = 65 years old. Eur J Cardiothorac Surg 1997;11:1133-40.
- 4) Hirose H, Amano A, Yoshida S, Takahashi A, Nagano N, Kohmoto T. Coronary artery bypass grafting in the elderly. Chest 2000;117:1262-70.
- 5) Pride NB. Ageing and changes in lung mechanics. Eur Respir J 2005;26:563-5.
- 6) Ragnarsdóttir M, KristjAnsdóttir A, Ingvarsdóttir I, Hannesson P, Torfason B, Cahalin L. Short-term changes in pulmonary function and respiratory movements after cardiac surgery via median sternotomy. Scand Cardiovasc J 2004;38:46-52.
- 7) Gürses HN, Yurdalan U, Polat MG, Güzelsoy D, Bakay C, Aytaç A, et al. Pre and postoperative ventilation function tests in coronary artery by-pass surgery. Turkish Respiratory Journal 1992;12:247-57.
- 8) Locke TJ, Griffiths TL, Mould H, Gibson GJ. Rib cage mechanics after median sternotomy. Thorax 1990;45:465-8.
- 9) Siafakas NM, Mitrouska I, Bouros D, Georgopoulos D. Surgery and the respiratory muscles. Thorax 1999;54:458-65.
- 10) van Belle AF, Wesseling GJ, Penn OC, Wouters EF. Postoperative pulmonary function abnormalities after coronary artery bypass surgery. Respir Med 1992;86:195-9.
- 11) Weiner P, Zeidan F, Zamir D, Pelled B, Waizman J, Beckerman M, et al. Prophylactic inspiratory muscle training in patients undergoing coronary artery bypass graft. World J Surg 1998;22:427-31.
- 12) Staton GW, Williams WH, Mahoney EM, Hu J, Chu H, Duke PG, et al. Pulmonary outcomes of off-pump vs on-pump coronary artery bypass surgery in a randomized trial. Chest 2005;127:892-901.
- 13) Cimen S, Ozkul V, Ketenci B, Yurtseven N, Günay R, Ketenci B, et al. Daily comparison of respiratory functions between on-pump and off-pump patients undergoing CABG. Eur J Cardiothorac Surg 2003;23:589-94.
- 14) Akdur H, Yiğit Z, Arabaci UO, Kocazeybek BS, Gurses HN. Investigation of the relationship between of postoperative mechanical ventilation and complication incidence following coronary artery bypass graft. Med Sci Monit 2207; 13:105-10.
- 15) Standardization of spirometry, 1994 update. American Thoracic Society. Am J Respir Crit Care Med 1995;152:1107-36.
- 16) Kamburoff PL, Woitovitz HJ. Prediction of spirometric indices. Respiratory News Bulletin. England: Vitalograph Ltd 1973;17:9-15.
- 17) Pauwels RA, Buist AS, Calverley PM, Jenkins CR, Hurd SS. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. NHLBI/ WHO Global Initiative for Chronic Obstructive Lung Disease (GOLD) Workshop summary. Am J Respir Crit Care Med 2001;163:1256-76.
- 18) Black LF, Hyatt RE. Maximal respiratory pressures: normal values and relationship to age and sex. Am Rev Respir Dis 1969;99:696-702.
- 19) Enright PL, Adams AB, Boyle PJ, Sherrill DL. Spirometry and maximal respiratory pressure references from healthy Minnesota 65- to 85-year-old women and men. Chest 1995;108:663-9.
- 20) Griffith KA, Sherrill DL, Siegel EM, Manolio TA, Bonekat HW, Enright PL. Predictors of loss of lung function in the elderly: the Cardiovascular Health Study. Am J Respir Crit Care Med 2001;163:61-8.
- 21) American Thoracic Society/European Respiratory Society. ATS/ERS Statement on respiratory muscle testing. Am J Respir Crit Care Med 2002;166:518-624.
- 22) Enright PL, Kronmal RA, Manolio TA, Schenker MB, Hyatt RE. Respiratory muscle strength in the elderly. Correlates and reference values. Cardiovascular Health Study Research Group. Am J Respir Crit Care Med 1994;149:430-8.
- 23) Boyd WD, Desai ND, Del Rizzo DF, Novick RJ, McKenzie FN, Menkis AH. Off pump surgery decreases postoperative complications and resource utilization in the elderly. Ann Thorac Surg 1999;68:1490-3.
- 24) Wong DT, Cheng DC, Kustra R, Tibshirani R, Karski J, Carroll-Munro J, et al. Risk factors of delayed extubation, prolonged length of stay in the intensive care unit, and mortality in patients undergoing coronary artery bypass graft with fast-track cardiac anesthesia: a new cardiac risk score. Anesthesiology 1999;91:936-44.