Abstract 15992: Post Operative Outcomes After Cardiac Surgery in Patients With Interstitial Lung Disease
Introduction: Interstitial lung disease(ILD) is a risk factor for pulmonary complications after lung resection. Acute exacerbations are associated with high mortality. Surgical outcomes after cardiac surgery in patients with ILD have not been reported.
Methods: We queried electronic medical records of patients undergoing cardiac surgery from Jan. 2002 to May 2015. ILD was identified by ICD-9 codes and clinical documentation. Aortic procedures, VAD implantation, and heart transplants were excluded. A control cohort without lung disease was identified by matching 1:1 on STS risk score to a 0.5% caliper, procedure, age and gender. Outcomes included operative morbidity and postoperative survival. Median follow-up was 5.3yrs.
Results: There were 521 patients with ILD; 344 were matched to non-ILD controls. The two cohorts were comparable in proportions of women, smokers (56% vs 52%), age (70±11 yrs both) and STS score (3.87% vs 3.88%) for ILD and non-ILD respectively (all p>0.28). ILD patients were on more immunosuppressive therapy (13% vs 4%, p≤0.001) and 54 had idiopathic pulmonary fibrosis (IPF). More non-ILD patients had diabetes (38% vs 27% p≤0.001) and prior cardiac surgery (15% vs 8%, p=0.004). Operative mortality was 3.5% for ILD vs 2.0%, for non-ILD patients (p>0.35). ILD had more reintubations than did non-ILD patients (4% vs 1%, p=0.044), but ventilation hours were similar (8 vs 7, p=0.22). ILD patients had longer hospital stays (8 vs 7 days, p<0.001) and more 30-day readmissions (17% vs 9%, p<0.001). IPF, renal failure, diabetes, CHF and age were independent predictors of poor survival with HR 2.6(p<0.001), 2.4(p<0.001), 1.6(p<0.004), 1.4(p<0.007) and 1.1(p<0.0001) respectively (Figure).
Conclusion: Compared to matched controls, patients with ILD require more reintubations, longer hospital stays and readmissions after cardiac surgery. While operative mortality was comparable, ILD and particularly those with IPF had reduced postoperative survival.
Author Disclosures: J.I. Ejiofor: None. G.M. Hunninghake: None. A.V. Norman: None. F. Ramirez-Del Val: None. S. McGurk: None. M.P. Pelletier: None. S.F. Aranki: None. J. Rawn: None. P.S. Shekar: None. T. Kaneko: None.
- © 2016 by American Heart Association, Inc.