Objective: The risk factors of postoperative pulmonary complications (PPCs) have been extensively investigated in non-cardiac surgery and non-elderly adult patients undergoing cardiac surgery. However, data on elderly patients after cardiopulmonary bypass (CPB) is limited. This study aimed to evaluate the risk factors and short-term outcomes for PPCs in elderly patients undergoing CPB procedures.
Patients and Methods: Data from 660 patients who underwent CPB over a six-year period at a tertiary care hospital were collected. The primary outcome encompassed the incidence of PPCs, including re-intubation, postoperative mechanical ventilation exceeding 48 hours, pulmonary infection, pleural effusion requiring thoracic drainage, and acute respiratory distress syndrome. Missing data were managed using multiple imputation. Univariate analysis and the multiple logistic regression method were utilized to ascertain independent risk factors for PPCs.
Results: Among the 660 patients, PPCs were observed in 375 individuals (56.82%). Multiple logistic regression identified serum albumin levels < 40 g/L, type of surgery, CPB duration > 150 minutes, blood transfusion, and intra-aortic balloon pump use before extubation as independent risk factors for PPCs. Patients experiencing PPCs had prolonged mechanical ventilation, extended hospitalization and ICU stays, elevated postoperative mortality, and higher tracheotomy rates compared to those without PPCs.
Conclusion: Elderly patients following CPB displayed a substantially high incidence of PPCs, significantly impacting their prognosis. Additionally, this study identified five prominent risk factors associated with PPCs in this population. These findings enable clinicians to better recognize patients who may benefit from perioperative prevention strategies based on these risk factors.

Keywords: postoperative pulmonary complications, elderly patients, cardiopulmonary bypass, cardiac surgery


中文翻译：

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老年体外循环患者术后肺部并发症的危险因素和短期结局

目的：在非心脏手术和接受心脏手术的非老年成人患者中广泛研究了术后肺部并发症（PPC）的危险因素。然而，关于体外循环（CPB）后老年患者的数据有限。本研究旨在评估接受 CPB 手术的老年患者 PPC 的危险因素和短期结果。
患者和方法：收集了 660 名在三级医院六年内接受 CPB 的患者的数据。主要结局包括 PPC 的发生率，包括重新插管、术后机械通气超过 48 小时、肺部感染、需要胸腔引流的胸腔积液和急性呼吸窘迫综合征。使用多重插补来管理缺失数据。采用单变量分析和多元逻辑回归方法确定 PPC 的独立危险因素。
结果： 660 例患者中，375 例（56.82%）观察到 PPC。多元 Logistic 回归确定血清白蛋白水平 < 40 g/L、手术类型、CPB 持续时间 > 150 分钟、输血和拔管前使用主动脉内球囊泵是 PPC 的独立危险因素。与未接受 PPC 的患者相比，接受 PPC 的患者机械通气时间延长、住院时间和 ICU 停留时间延长、术后死亡率升高以及气管切开率更高。
结论： CPB 后的老年患者 PPC 发生率相当高，显着影响其预后。此外，这项研究还确定了与该人群中 PPC 相关的五个显着风险因素。这些发现使临床医生能够更好地识别可能受益于基于这些风险因素的围手术期预防策略的患者。

Keywords:术后肺部并发症, 老年患者, 体外循环, 心脏手术