Pre-operative Pulmonary Training Program in Coronary Artery Bypass Graft Surgery Patients at Siriraj Hospital

Abstract

Objective: To compare the incidence of pulmonary complications in coronary artery bypass graft surgery patients who underwent a pre-operative pulmonary training program to those who did not.

Methods: The patients with coronary artery disease who underwent elective coronary artery bypass graft (CABG) surgery at Siriraj Hospital from January to December 2007 were included in this study and were divided into two groups depending on whether they received a pre-operative pulmonary training program. The primary clinical variable was the presence or absence of pulmonary complications. The comparison of the pre-operative pulmonary training and non- pre-operative pulmonary training group was performed by the Chi-square test for the qualitative data and the Independent sample t-test for the quantitative data.

Results: A total of 627 patients were divided into two groups, the pre-operative pulmonary training group (G1) and non- pre-operative pulmonary training group (G2). Comparison between the two groups showed, pulmonary complications were significantly more frequent in G2 than in G1 (7.4% and 3.1%). The difference in incidence of pneumonia was also statistically significant (6.6% and 0.8% in G2 and G1), respectively. The odds ratio for total pneumonia of G2 was 9.3, 95% CI [2.1, 57.3] and for total pulmonary complication of G2 was 2.6, 95% CI [1.1, 6.3]. G2 also had a longer length of stay than G1 (11.0 ± 10.3 and 15.3 ± 12.2 days), respectively.

Conclusion: A pre-operative pulmonary training program can prevent post-operative pulmonary complications and reduce the length of hospital stay in patients who underwent coronary artery bypass surgery.