[Pneumonia in patients undergoing heart surgery].

OBJECTIVE

We performed a follow-up study of 104 consecutive patients who underwent cardiac surgery to ascertain the following: 1) the incidence of nosocomial pneumonia (NP) in this patient population; 2) the differences in the incidence of NP between patients who underwent coronary artery bypass grafting (CABG) vs. valvular replacement (VR), and 3) the identification of risk factors which predispose patients to the development of NP.

RESULTS

The study included 104 patients of which 49 underwent VR, 43 CABG and 12 who had both procedures performed simultaneously. Six of the 104 patients developed NP (5.7%). Five of these patients had undergone VR where as opposed to only one in the CABG group. Pulmonary hypertension preoperatively was a risk factor for the development of NP. Of the 49 patients in the VR group, 46 had pulmonary artery pressures (PAP) recorded, and from their 23 (50%) had pulmonary hypertension. However, 4 of the 5 (80%) patients who developed NP had elevated PAP. The mortality among patients with NP was high. Sixty six percent of patients (4/6) with NP died in comparison to the 10 deaths (10.2%) among 92 patients without NP (p = 0.002).

CONCLUSIONS

A trend in the development of NP was observed in patients who underwent valve replacement as opposed to CABG. Because of the small number of patients who developed pneumonia in the study population statistical significance cannot be reached. Pulmonary hypertension in the post operative period is a risk factor for the development of NP. Mortality among patients who develop NP is significantly high (p = 0.002).