Analysis of risk factors of respiratory critical illness after cardiac surgery in the elderly
Objective To analyze the risk factors of respiratory critical illness after cardiac surgery in the elderly.Methods A total of 686 inpatients who underwent cardiac surgery in Fuwai Central China Cardiovascular Hospital from May to November 2022 were retrospectively selected as the study objects,and they were divided into a PPCs group(122 cases)and a control group(564 cases)according to whether the postoperative pulmonary complications(PPCs)occurred.After collecting the patients'baseline information,univariate analysis was performed for each index,and the indexes with P＜0.05 were included in the multivariate logistic regression analysis.With the occurrence of PPCs as the dependent variable and baseline characteristics as the independent variables,multivariate logistic regression analysis was used to determine the independent risk factors for PPCs.x2 test was used.Results There were 65 males and 57 females in the PPCs group,86 cases(70.49％)aged ≥70 years,and 82 cases(67.21％)with course of disease＞3 years.There were 293 males and 271 females in the control group,304 cases(53.90％)aged ≥70 years,and 242 cases(42.91％)with course of disease＞3 years.Logistic regression analysis showed that age ≥70 years old(OR=4.855,95％CI:1.981-7.728),course of disease＞3 years(OR=4.678,95％CI:1.908-7.447),smoking history＞3 years(OR=23.248,95％CI:9.843-36.653),initial New York Heart Association(NYHA)grade Ⅲ-Ⅳ(OR=4.567,95％CI:1.984-7.150),hypertension(OR=29.871,95％CI:11.390-48.352),diabetes(OR=4.343,95％CI:1.875-6.812),asthma(OR=31.134,95％CI:13.612-48.655),apnea syndrome(OR=3.282,95％CI:1.317-5.247),operation time＞45 min(OR=18.722,95％CI:6.781-30.663),operation in supine position(OR=4.299,95％CI:1.598-7.000),lung compliance T value＜70％of normal value(OR=6.826,95％CI:2.627-11.025),anemia(OR=4.150,95％CI:1.696-6.603),emergency surgery(OR=23.495,95％CI:8.998-37.991),and chronic obstructive pulmonary disease(COPD)(OR=5.663,95％CI:2.004-9.322)were the risk factors of respiratory critical illness after cardiac surgery in the elderly(all P＜0.05).Conclusions The logistic risk predictors of respiratory critical illness after cardiac surgery in the elderly are clear,which can effectively predict the occurrence of complications.We look forward to conducting large-sample,prospective evidence-based clinical trials to improve the prediction equation.
万方数据
维普
