Complicações pulmonares após cirurgia de revascularização do miocárdio: fatores associados
Pulmonary complications after coronary artery bypass surgery: factors associated factors
Katerine Cristhine Cani, Kelly Cattelan Bonorino, Aline Almeida Gulart, Marina Palú, Manuela Karloh, Anamaria Fleig Mayer
Resumo
Introdução: A cirurgia de revascularização do miocárdio (CRM) está associada a efeitos deletérios sobre a função pulmonar. Esses efeitos podem estar relacionados ao tipo de cirurgia, tempo de internação e à presença de comorbidades, que contribuem para o risco de complicações pulmonares pós-operatórias (CPPO). Objetivo: Investigar quais fatores estão associados às CPPO em pacientes submetidos à CRM. Métodos: Trata-se de um estudo prospectivo observacional. Participaram do estudo 48 pacientes submetidos à CRM, divididos em: grupo complicações pulmonares e grupo sem complicações pulmonares. Os dados foram coletados mediante entrevista e levantamento de dados dos prontuários. Na análise estatística, a normalidade das variáveis foi verificada com o Teste de Shapiro-Wilk; o Teste exato de Fisher, para analisar a existência ou não de associação entre as CPPO e a presença de fatores relacionados; para comparação entre os grupos, utilizou-se o Teste U de Mann Whitney. Resultados: A amostra era predominantemente do sexo masculino (72,9%), com média de idade de 59,9±11,1 anos. As CPPO foram identificadas em 64,6% dos pacientes, sendo a maioria de Grau 1 (61,3%). A presença de doença pulmonar obstrutiva crônica foi o único fator que apresentou associação com as CPPO. O tempo de internação hospitalar/UTI foi maior no grupo complicações pulmonares (p<0,05). Conclusão: A doença pulmonar obstrutiva crônica foi o único fator que apresentou associação com as complicações pulmonares em pacientes submetidos à cirurgia de revascularização do miocárdio. Em adição, o tempo de internação hospitalar, nos pacientes que apresentaram complicações pulmonares, foi maior, em comparação aos pacientes que não apresentaram.
Palavras-chave
Abstract
Background: Cardiac surgery for coronary artery bypass grafting (CABG) is associated with deleterious effects on lung function. These effects may be related to factors inherent to surgery, the hospital stay and the presence of comorbidities that contribute to the risk of postoperative pulmonary complications (PPC). Objective: To investigate what factors are associated with PPC in patients undergoing CABG. Methods: This is a prospective and observational cohort study. Forty-eight patients undergoing CABG participated in the study and were separated into two groups: group with postoperative pulmonary complications and group without postoperative pulmonary complications. Data was collected via interviews and investigation of patients’ medical records. In the statistical analysis, the normality of the variables was assessed using the Shapiro-Wilk test; Fisher’s exact test was used to analyze the existence of associations between the presence of PPC and related factors; between groups comparisons were done using the Mann Whitney U test. Results: The sample was predominantly composed of men (72.9%) with mean age of 59.9 ± 11.1 years. PPC was identified in 64.6% of patients, most of whom classified as grade 1 (61.3%). The presence of chronic obstructive pulmonary disease was the only factor that was associated with PPC. The hospital / ICU stay was longer in the postoperative pulmonary complications group (p <0.05). Conclusion: Chronic obstructive pulmonary disease was the only factor that was associated with postoperative pulmonary complications in patients undergoing CABG. Length of hospital stay in patients with pulmonary complications was longer compared to patients without complications.
Keywords
Referências
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