Factors Influencing the Incidence of Pneumonia after Coronary Artery Bypass Grafting
DOI:
https://doi.org/10.59958/hsf.6865Keywords:
pneumonia after coronary artery bypass grafting, influencing factors, pathogenic bacteria, infusion volume of suspended red blood cellsAbstract
Objective: This study aimed to explore and analyze the factors affecting the incidence of pneumonia after coronary artery bypass grafting (CABG) to provide reference for the prevention of such situation. Methods: A total of 500 patients who underwent CABG in a hospital were selected. From March 2019 to March 2022, 410 patients without pneumonia and 90 patients with pneumonia were divided into groups A and B. The influencing factors and pathogen composition of postoperative pneumonia were discussed and analyzed. Results: Univariable analysis results showed that age, cardiac function grade, occurrence of smoking, operation time, tracheal intubation time, suspended red-blood-cell transfusion and hospital stay in group B were higher than those in group A. Multivariable logistic analysis results showed that operation time, smoking history, and tracheal intubation time were risk factors for pneumonia after CABG. Among the 90 patients with postoperative pneumonia, 90 had pathogens, 81 had Gram-negative bacteria, 4 had Gram-positive bacteria, and 5 had fungi. Conclusions: Patients after CABG were more likely to develop pneumonia. Operation time, smoking history, and tracheal intubation time were the risk factors of pneumonia after CABG. Most of these patients had Gram-negative bacteria. Patient intervention based on the influencing factors can effectively prevent the occurrence of postoperative pneumonia.
References
Figtree GA, Adamson PD, Antoniades C, Blumenthal RS, Blaha M, Budoff M, et al. Noninvasive Plaque Imaging to Accelerate Coronary Artery Disease Drug Development. Circulation. 2022; 146: 1712–1727.
Golforoush P, Yellon DM, Davidson SM. Mouse models of atherosclerosis and their suitability for the study of myocardial infarction. Basic Research in Cardiology. 2020; 115: 73.
Shaefi S, Mittel A, Loberman D, Ramakrishna H. Off-Pump Versus On-Pump Coronary Artery Bypass Grafting-A Systematic Review and Analysis of Clinical Outcomes. Journal of Cardiothoracic and Vascular Anesthesia. 2019; 33: 232–244.
Khan FM, Hameed I, Milojevic M, Wingo M, Krieger K, Girardi LN, et al. Quality metrics in coronary artery bypass grafting. International Journal of Surgery (London, England). 2019; 65: 7–12.
Une D, Sakaguchi T. Initiation and modification of minimally invasive coronary artery bypass grafting. General Thoracic and Cardiovascular Surgery. 2019; 67: 349–354.
Bianco V, Kilic A, Gleason TG, Aranda-Michel E, Wang Y, Navid F, et al. Timing of coronary artery bypass grafting after acute myocardial infarction may not influence mortality and readmissions. The Journal of Thoracic and Cardiovascular Surgery. 2021; 161: 2056–2064.e4.
Li Y, Zhang J, He Z. Early Predictive Value of Procalcitonin for the Diagnosis of Pulmonary Infections after Off-pump Coronary Artery Bypass Grafting. The Heart Surgery Forum. 2021; 24: E004–E008.
Liu X, Wang L, Wang S, Zhang W, Yu Y, Chen S, et al. Association Between Infection and Thrombosis After Coronary Artery Bypass Grafting: A Cohort Study. Journal of Cardiothoracic and Vascular Anesthesia. 2019; 33: 1610–1616.
Nicolini F, Vezzani A, Romano G, Carino D, Ricci M, Chicco MVD, et al. Coronary Artery Bypass Grafting with Arterial Conduits in the Elderly. International Heart Journal. 2017; 58: 647–653.
Mali S, Haghaninejad H. Pulmonary complications following cardiac surgery. Archives of Medical Sciences. Atherosclerotic Diseases. 2019; 4: e280–e285.
Atik FA, Pegado HM, de Brito LMR, Macedo MT, França EP, Jr, Dias AKA, et al. Does the anthropometric profile influence infection morbidity after coronary artery bypass grafting? Journal of Cardiac Surgery. 2021; 36: 1194–1200.
Chen K, Scridon T, Chait R. Inadvertent aortocoronary arteriovenous fistula after CABG: Systematic review of case reports. Catheterization and Cardiovascular Interventions: Official Journal of the Society for Cardiac Angiography & Interventions. 2021; 97: E19–E25.
Gao J, Wang H, Liu X, Song X, Zhong X. Surgical site wound infection, and other postoperative problems after coronary artery bypass grafting in subjects with chronic obstructive pulmonary disease: A meta-analysis. International Wound Journal. 2023; 20: 302–312.
Ho CH, Chen YC, Chu CC, Wang JJ, Liao KM. Postoperative Complications After Coronary Artery Bypass Grafting in Patients With Chronic Obstructive Pulmonary Disease. Medicine. 2016; 95: e2926.
Ge YL, Zhu XY, Hu K, Zhang Q, Li WQ, Zhang C, et al. Positive Serum Beta-D-glucan by G Test and Aspergillus Fumigatus Sputum Culture Mimic Invasive Pulmonary Aspergillosis in a Pulmonary Nocardia Patient: a Case Report and Literature Review. Clinical Laboratory. 2019; 65: 10.7754/Clin.Lab.2018.181105.
Ren J. Opportunities and challenges in general practice: A Chinese perspective. International Journal of General Practice. 2022; 1: 21–37.
Wang X. Incidence and prevention of chronic diseases in China: Literature review in the last 5 years. International Journal of General Practice. 2022; 1: 57–70.
Kitamura H, Tamaki M, Kawaguchi Y, Okawa Y. Results of off-pump coronary artery bypass grafting with off-pump first strategy in octogenarian. Journal of Cardiac Surgery. 2021; 36: 4611–4616.
Sandler N, Ho H, Draxler DF, Bain CR, Smith JA, Hauser CJ, et al. Characterisation of Plasma Mitochondrial DNA, MMP-9 and Neutrophil Elastase in Patients Undergoing Coronary Artery Bypass Grafting: Effects of Tranexamic Acid and Postoperative Pneumonia. Heart, Lung & Circulation. 2022; 31: 439–446.
Rosenblum JM, Binongo J, Wei J, Liu Y, Leshnower BG, Chen EP, et al. Priorities in coronary artery bypass grafting: Is midterm survival more dependent on completeness of revascularization or multiple arterial grafts? The Journal of Thoracic and Cardiovascular Surgery. 2021; 161: 2070–2078.e6.
Gaudino M, Taggart DP. Percutaneous Coronary Intervention vs Coronary Artery Bypass Grafting: A Surgical Perspective. JAMA Cardiology. 2019; 4: 505–506.
Sumi K, Yoshida S, Okamura Y, Isomura T. Minimally Invasive Multiple Coronary Artery Bypass Grafting with Composite Graft Using in situ Right Gastroepiploic and Radial Arteries. Annals of Thoracic and Cardiovascular Surgery: Official Journal of the Association of Thoracic and Cardiovascular Surgeons of Asia. 2021; 27: 286–289.
Modi AR, Kovacs CS. Hospital-acquired and ventilator-associated pneumonia: Diagnosis, management, and prevention. Cleveland Clinic Journal of Medicine. 2020; 87: 633–639.
Puskas JD, Gaudino M, Taggart DP. Experience Is Crucial in Off-Pump Coronary Artery Bypass Grafting. Circulation. 2019; 139: 1872–1875.
Łoś A, Hellmann M. Real-time microcirculation imaging during beating-heart coronary artery bypass grafting. Kardiologia Polska. 2020; 78: 780–781.
Galambos C, Bush D, Abman SH. Intrapulmonary bronchopulmonary anastomoses in COVID-19 respiratory failure. The European Respiratory Journal. 2021; 58: 2004397.
Wang Z, Zhang Y, Duan M, Zhang Y. Chronic active Epstein-Barr virus infection with intrapulmonary shunting: A case report. Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy. 2020; 26: 502–505.
Ngom NF, Sow D, Diedhiou D, Ndour MA, Diop CT, Faye FA, et al. Epidemiological, Clinical, Paraclinical and Evolutionary Aspects of Urinary Tract Infection in Diabetics Hospitalized at the Department of Medicine of Abass Ndao Hospital from January 01, 2018, to December 31, 2018. Advances in Infectious Diseases. 2022; 12: 203–215.
Turk Wensveen T, Gašparini D, Rahelić D, Wensveen FM. Type 2 diabetes and viral infection; cause and effect of disease. Diabetes Research and Clinical Practice. 2021; 172: 108637.
Bal T, Kurtdere C, Önlen Y, Çabalak M. Effect of Hepatitis C Infection and Its Clearance on the Frequency of Coronary Artery Disease in Diabetics. Viral Hepatitis Journal. 2020; 26: 167–170.
Ono M, Kawashima H, Hara H, Mancone M, Mack MJ, Holmes DR, et al. Impact of major infections on 10-year mortality after revascularization in patients with complex coronary artery disease. International Journal of Cardiology. 2021; 341: 9–12.
Suryawan IGR, Luke K, Agustianto RF, Mulia EPB. Coronary stent infection: a systematic review. Coronary Artery Disease. 2022; 33: 318–326.
Weissman C. Pulmonary complications after cardiac surgery. Seminars in Cardiothoracic and Vascular Anesthesia. 2004; 8: 185–211.
Hulzebos EHJ, Helders PJM, Favié NJ, De Bie RA, Brutel de la Riviere A, Van Meeteren NLU. Preoperative intensive inspiratory muscle training to prevent postoperative pulmonary complications in high-risk patients undergoing CABG surgery: a randomized clinical trial. JAMA. 2006; 296: 1851–1857.
Chen X, Hou L, Zhang Y, Liu X, Shao B, Yuan B, et al. The effects of five days of intensive preoperative inspiratory muscle training on postoperative complications and outcome in patients having cardiac surgery: a randomized controlled trial. Clinical Rehabilitation. 2019; 33: 913–922.
Langnau C, Rohlfing AK, Gekeler S, Günter M, Pöschel S, Petersen-Uribe Á, et al. Platelet Activation and Plasma Levels of Furin Are Associated With Prognosis of Patients With Coronary Artery Disease and COVID-19. Arteriosclerosis, Thrombosis, and Vascular Biology. 2021; 41: 2080–2096.
Shen Y, Cao Q, Zhuo H, Hu M, Chen S. Early Versus Late Tracheostomy in Stroke Patients: A Retrospective Analysis. Neuropsychiatric disease and treatment. 2022; 18: 2713–2723.
Kolossvary M, Fishman EK, Gerstenblith G, Bluemke DA, Mandler RN, Kickler TS, et al. HIV may indirectly accelerate coronary artery disease through enhancing the effects of conventional and non-conventional cardiovascular risk factors. European Heart Journal. 2020; 2: ehaa946. 3310.
Enginoev S, Rad AA, Ekimov S, Kondrat'ev D, Magomedov G, Amirhanov A, et al. Risk Factors for Deep Sternal Wound Infection after Off-Pump Coronary Artery Bypass Grafting: a Case-Control Study. Brazilian Journal of Cardiovascular Surgery. 2022; 37: 13–19.
