![]() The study was registered on (identifier NCT03409055). With the written consent of the federal data protection officer and the hospital ethics commission, routine clinical data from all eligible patients were extracted from the hospital’s IT system to an anonymized study database. This study was carried out with the aim of determining the clinical outcomes of pleural effusions in propensity-matched patients during early recovery from cardiac surgery.Īll patients undergoing cardiac surgery between 20 at a tertiary care university hospital were included in this observational, cross-sectional analysis. However, it is unclear whether pleural effusions are only concomitant symptoms of more complicated cases involving patients with outcome-limiting comorbidities, or if they are themselves associated with impaired outcomes. Causes of pleural effusions after cardiac surgery include diaphragm dysfunction, internal mammary artery harvesting (only in internal mammary artery grafting), and other perioperative complications (e.g., sepsis, congestive heart failure, pulmonary embolism, and chylothorax). Clinically significant effusions can delay recovery in the hospital and beyond, and are a critical source of hospital readmissions after discharge. Thus, pulmonary function in patients with pleural effusion post–internal mammary artery grafting is significantly impaired compared to patients without pleural changes. ![]() Symptomatic patients with pleural effusions may complain of shortness of breath, cough, and chest pain. Of patients undergoing coronary artery bypass grafting or heart valve surgery, between 41% and 89% develop pleural effusions in the first 7 days after surgery and 10% develop a pleural effusion occupying more than 25% of the hemithorax in the subsequent month. Pleural effusions occur frequently in patients recovering from cardiac surgery. These insights may be of great interest to scientists, clinicians, and industry leaders alike to foster research into innovative methods for preventing and treating pleural effusions with the aim of improving outcomes for patients recovering from cardiac surgery. Pleural effusions, especially those that require a secondary drainage procedure during recovery, are associated with significantly worse outcomes including increased mortality, longer length of stay, and higher complication rates. Patients with pleural effusions had a higher incidence of hemodialysis (246 in Group 2, 137 in Group 1, 98 in Group 0), and a longer ventilation time in the ICU (57 hours in Group 2, 25.0 hours in Group 1, 16.0 hours in Group 0). Intensive care unit (ICU) stay was longer for those with pleural effusions (18 days in Group 2, 10 days for Group 1, and 7 days for Group 0, p < 0.001). After propensity matching, the mortality of patients who underwent secondary drainage procedures was 6.1% higher than in Group 1 ( p < 0.001). Of 11,037 patients that underwent cardiac surgery during the study period, 6461 (58.5%) had no pleural effusion (Group 0), 3322 (30.1%) had pleural effusion only (Group 1), and 1254 (11.4%) required at least one secondary drainage procedure after the index operation (Group 2). ![]() MethodsĪll patients undergoing cardiac surgery between 20 at a tertiary care university hospital were included in this observational, cross-sectional analysis using propensity matching. The purpose of this study is to characterize the clinical outcomes of cardiac surgery patients with pleural effusion. Pleural effusions commonly occur in patients recovering from cardiac surgery however, the impact on outcomes is not well characterized.
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