Incidence and Risk Factors of Postoperative Pulmonary Complications Following On-Pump Cardiac Surgery at a Tertiary Care Center in Pakistan

Abstract

Objectives: Pulmonary complications following on-pump cardiac surgery are a well-recognized cause of increased morbidity and mortality. However, limited studies have explored the associated risk factors in patients undergoing cardiac surgery with the use of cardiopulmonary bypass (CPB). This study aimed to assess the frequency and associated risk factors of postoperative pulmonary complications (PPCs) in a cohort of adult patients who underwent on-pump cardiac surgery. Methodology: This descriptive study was conducted from 31st May 2022 to 10th December 2022 in the Adult Cardiac Surgery Department of the National Institute of Cardiovascular Diseases (NICVD), Karachi. Adult patients aged 18 to 80 years who underwent elective on-pump cardiac surgery were prospectively analyzed. Descriptive statistics were used to explore risk factors for PPCs, while chi-square and Fisher’s exact tests were applied to determine statistical associations. Results: A total of 371 patients were included, with a mean age of 54.1 ± 12.2 years and a mean BMI of 27.2 ± 5.1 kg/m². Males comprised 73% (n=271) of the cohort, while females made up 27% (n=100). Postoperative pulmonary complications occurred in 13.2% of patients. Hypertension was the most prevalent comorbidity, affecting 38% (n=141) of participants. The most common PPCs were pleural effusion (5.7%), ARDS (3.2%), pneumonia (2.7%), and atelectasis (1.6%). Conclusion: Several clinical and perioperative factors contribute to the incidence of PPCs following cardiac surgery on CPB. Early identification of these risk factors may enable timely interventions and improve surgical outcomes.