Influenza Season and Outcome After Elective Cardiac Surgery: An Observational Cohort Study.

Autor: Swets MC; Department of Infectious Diseases, Leiden University Medical Center, Leiden University, Leiden, Netherlands; Roslin Institute, University of Edinburgh, Edinburgh, United Kingdom., Termorshuizen F; Department of Medical Informatics, Amsterdam University Medical Center, Amsterdam, Netherlands; National Intensive Care Evaluation Foundation, Amsterdam, Netherlands., de Keizer NF; Department of Medical Informatics, Amsterdam University Medical Center, Amsterdam, Netherlands; National Intensive Care Evaluation Foundation, Amsterdam, Netherlands., van Paassen J; Department of Intensive Care Medicine, Leiden University Medical Center, Leiden University, Leiden, Netherlands., Palmen M; Department of Cardiothoracic Surgery, Leiden University Medical Center, Leiden University, Leiden, Netherlands., Visser LG; Department of Infectious Diseases, Leiden University Medical Center, Leiden University, Leiden, Netherlands., Arbous MS; National Intensive Care Evaluation Foundation, Amsterdam, Netherlands; Department of Intensive Care Medicine, Leiden University Medical Center, Leiden University, Leiden, Netherlands., Groeneveld GH; Department of Infectious Diseases, Leiden University Medical Center, Leiden University, Leiden, Netherlands; Department of Internal Medicine-Acute Medicine, Leiden University Medical Center, Leiden University, Leiden, Netherlands. Electronic address: g.h.groeneveld@lumc.nl.
Jazyk: angličtina
Zdroj: The Annals of thoracic surgery [Ann Thorac Surg] 2023 Dec; Vol. 116 (6), pp. 1161-1167. Date of Electronic Publication: 2023 Feb 18.
DOI: 10.1016/j.athoracsur.2023.01.041
Abstrakt: Background: An asymptomatic respiratory viral infection during cardiac surgery could lead to pulmonary complications and increased mortality. For elective surgery, testing for respiratory viral infection before surgery or vaccination could reduce the number of these pulmonary complications. The aim of this study was to investigate the association between influenzalike illness (ILI) seasons and prolonged mechanical ventilation and inhospital mortality in a Dutch cohort of adult elective cardiac surgery patients.
Methods: Cardiac surgery patients who were admitted to the intensive care unit between January 1, 2014, and February 1, 2020, were included. The primary endpoint was the duration of invasive mechanical ventilation in the ILI season compared with baseline season. Secondary endpoints were the median Pao 2 to fraction of inspired oxygen ratio on days 1, 3, and 7 and postoperative inhospital mortality.
Results: A total of 42,277 patients underwent cardiac surgery, 12,994 (30.7%) in the ILI season, 15,843 (37.5%) in the intermediate season, and 13,440 (31.8%) in the baseline season. No hazard rates indicative of a longer duration of invasive mechanical ventilation during the ILI season were found. No differences were found for the median Pao 2 to fraction of inspired oxygen ratio between seasons. However, inhospital mortality was higher in the ILI season compared with baseline season (odds ratio 1.67; 95% CI, 1.14-2.46).
Conclusions: Patients undergoing cardiac surgery during the ILI season were at increased risk of inhospital mortality compared with patients in the baseline season. No evidence was found that this difference is caused by direct postoperative pulmonary complications.
(Copyright © 2023 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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