ABSTRACT
AIM: The aim of this study was to evaluate whether pulmonary function as assessed by spirometry affects the immediate and late outcome after isolated coronary artery bypass surgery (CABG). METHODS: Data on preoperative percentages of the predicted forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) were retrieved from a series of 1848 patients who underwent isolated CABG. Pulmonary disease was defined according to EuroSCORE criteria. RESULTS: Logistic regression showed that percentage of predicted FVC was an independent predictor of in-hospital mortality along with estimated glomerular filtration rate, age and extracardiac arteriopathy. Cox regression analysis showed that pulmonary disease and percentages of predicted FVC were independent predictors of late overall mortality. Percentage of predicted FVC < 70% (at 10-year: 63.8% vs. 74.3%, Cox regression analysis: P = 0.014, RR 1.50, 95%C.I. 1.08-2.08) and pulmonary disease (at 10-year: 58.0% vs. 76%, Cox regression analysis: P < 0.0001, RR 1.75, 95%C.I. 1.29-2.39), but not percentage of predicted FEV1 < 70%, were associated with a marked decrease in late survival. CONCLUSION: This study confirmed the significant, negative prognostic impact of pulmonary disease on the immediate and long-term survival after isolated CABG.
Subject(s)
Coronary Artery Bypass , Lung Diseases/complications , Lung/physiopathology , Age Factors , Aged , Chi-Square Distribution , Coronary Artery Bypass/adverse effects , Coronary Artery Bypass/mortality , Databases as Topic , Female , Finland , Forced Expiratory Volume , Glomerular Filtration Rate , Hospital Mortality , Humans , Kaplan-Meier Estimate , Logistic Models , Lung Diseases/physiopathology , Male , Middle Aged , Proportional Hazards Models , Risk Assessment , Risk Factors , Spirometry , Time Factors , Treatment Outcome , Vascular Diseases/complications , Vital CapacitySubject(s)
Hospitals, University/standards , Intensive Care Units/standards , Treatment Outcome , Wounds and Injuries/mortality , Wounds and Injuries/therapy , APACHE , Adolescent , Adult , Critical Care , Data Interpretation, Statistical , Female , Finland , Hospital Mortality , Humans , Male , Middle Aged , Young AdultABSTRACT
Four patients who developed endometriosis at the episiotomy scar are reported. The latent period varied from 6 months to 10 years before the onset of symptoms. Three of them experienced cyclic pain at the site of the lesion during their menses and one patient had bloody discharge from the scar during menstruation. All patients were managed surgically and no one had recurrence during the follow-up period which ranged from 2 to 5 years. The pathogenesis of endometriosis is discussed as a clinical entity; the literature is also reviewed.
