Pulmonary embolism in the cardiac surgical patient

A. Marc Gillinov, Elizabeth A. Davis, Anthony J. Alberg, Mary Rykiel, Timothy J. Gardner, Duke E. Cameron

Research output: Contribution to journalArticle

Abstract

Pulmonary embolism (PE) is thought to occur infrequently after cardiac operations, possibly because systemic heparinization during cardiopulmonary bypass prevents deep vein thrombosis. This retrospective study was undertaken to determine the actual incidence of PE after cardiac operations and to identify risk factors. Between January 1, 1985, and December 31, 1989, 5,694 adult patients (>18 years old) had open heart operations at the Johns Hopkins Hospital. Thirty-two patients (20 men and 12 women) had PE within 60 days of operation, an overall PE incidence of 0.56%. The diagnosis of PE was established by ventilation/perfusion scan, pulmonary angiogram, or autopsy. Mortality among patients with PE was 34%. Using a case-control method, preoperative and postoperative risk factors for PE were identified by multivariate and multiple logistic regression analyses. Preoperative risk factors included bed rest (p <0.003), prolonged hospitalization before operation (p <0.004), and cardiac catheterization performed through the groin within 15 days before operation (p <0.01). Postoperative risk factors were congestive heart failure (p <0.008), prolonged bed rest (p <0.05), and deep vein thrombosis (p <0.03). This study demonstrates that PE is an unusual complication after cardiac operations, has a high mortality rate, and is often related to perioperative immobility and recent groin catheterization. These results also suggest that minimizing preoperative hospital stay may be important in PE prophylaxis.

Original languageEnglish (US)
Pages (from-to)988-991
Number of pages4
JournalAnnals of Thoracic Surgery
Volume53
Issue number6
DOIs
StatePublished - 1992

Fingerprint

Pulmonary Embolism
Bed Rest
Groin
Venous Thrombosis
Mortality
Incidence
Cardiac Catheterization
Cardiopulmonary Bypass
Catheterization
Ventilation
Autopsy
Length of Stay
Angiography
Hospitalization
Heart Failure
Retrospective Studies
Perfusion
Logistic Models
Regression Analysis
Lung

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Gillinov, A. M., Davis, E. A., Alberg, A. J., Rykiel, M., Gardner, T. J., & Cameron, D. E. (1992). Pulmonary embolism in the cardiac surgical patient. Annals of Thoracic Surgery, 53(6), 988-991. https://doi.org/10.1016/0003-4975(92)90372-B

Pulmonary embolism in the cardiac surgical patient. / Gillinov, A. Marc; Davis, Elizabeth A.; Alberg, Anthony J.; Rykiel, Mary; Gardner, Timothy J.; Cameron, Duke E.

In: Annals of Thoracic Surgery, Vol. 53, No. 6, 1992, p. 988-991.

Research output: Contribution to journalArticle

Gillinov, AM, Davis, EA, Alberg, AJ, Rykiel, M, Gardner, TJ & Cameron, DE 1992, 'Pulmonary embolism in the cardiac surgical patient', Annals of Thoracic Surgery, vol. 53, no. 6, pp. 988-991. https://doi.org/10.1016/0003-4975(92)90372-B
Gillinov AM, Davis EA, Alberg AJ, Rykiel M, Gardner TJ, Cameron DE. Pulmonary embolism in the cardiac surgical patient. Annals of Thoracic Surgery. 1992;53(6):988-991. https://doi.org/10.1016/0003-4975(92)90372-B
Gillinov, A. Marc ; Davis, Elizabeth A. ; Alberg, Anthony J. ; Rykiel, Mary ; Gardner, Timothy J. ; Cameron, Duke E. / Pulmonary embolism in the cardiac surgical patient. In: Annals of Thoracic Surgery. 1992 ; Vol. 53, No. 6. pp. 988-991.
@article{477c2e00f7e24636921082730dca78b5,
title = "Pulmonary embolism in the cardiac surgical patient",
abstract = "Pulmonary embolism (PE) is thought to occur infrequently after cardiac operations, possibly because systemic heparinization during cardiopulmonary bypass prevents deep vein thrombosis. This retrospective study was undertaken to determine the actual incidence of PE after cardiac operations and to identify risk factors. Between January 1, 1985, and December 31, 1989, 5,694 adult patients (>18 years old) had open heart operations at the Johns Hopkins Hospital. Thirty-two patients (20 men and 12 women) had PE within 60 days of operation, an overall PE incidence of 0.56{\%}. The diagnosis of PE was established by ventilation/perfusion scan, pulmonary angiogram, or autopsy. Mortality among patients with PE was 34{\%}. Using a case-control method, preoperative and postoperative risk factors for PE were identified by multivariate and multiple logistic regression analyses. Preoperative risk factors included bed rest (p <0.003), prolonged hospitalization before operation (p <0.004), and cardiac catheterization performed through the groin within 15 days before operation (p <0.01). Postoperative risk factors were congestive heart failure (p <0.008), prolonged bed rest (p <0.05), and deep vein thrombosis (p <0.03). This study demonstrates that PE is an unusual complication after cardiac operations, has a high mortality rate, and is often related to perioperative immobility and recent groin catheterization. These results also suggest that minimizing preoperative hospital stay may be important in PE prophylaxis.",
author = "Gillinov, {A. Marc} and Davis, {Elizabeth A.} and Alberg, {Anthony J.} and Mary Rykiel and Gardner, {Timothy J.} and Cameron, {Duke E.}",
year = "1992",
doi = "10.1016/0003-4975(92)90372-B",
language = "English (US)",
volume = "53",
pages = "988--991",
journal = "Annals of Thoracic Surgery",
issn = "0003-4975",
publisher = "Elsevier USA",
number = "6",

}

TY - JOUR

T1 - Pulmonary embolism in the cardiac surgical patient

AU - Gillinov, A. Marc

AU - Davis, Elizabeth A.

AU - Alberg, Anthony J.

AU - Rykiel, Mary

AU - Gardner, Timothy J.

AU - Cameron, Duke E.

PY - 1992

Y1 - 1992

N2 - Pulmonary embolism (PE) is thought to occur infrequently after cardiac operations, possibly because systemic heparinization during cardiopulmonary bypass prevents deep vein thrombosis. This retrospective study was undertaken to determine the actual incidence of PE after cardiac operations and to identify risk factors. Between January 1, 1985, and December 31, 1989, 5,694 adult patients (>18 years old) had open heart operations at the Johns Hopkins Hospital. Thirty-two patients (20 men and 12 women) had PE within 60 days of operation, an overall PE incidence of 0.56%. The diagnosis of PE was established by ventilation/perfusion scan, pulmonary angiogram, or autopsy. Mortality among patients with PE was 34%. Using a case-control method, preoperative and postoperative risk factors for PE were identified by multivariate and multiple logistic regression analyses. Preoperative risk factors included bed rest (p <0.003), prolonged hospitalization before operation (p <0.004), and cardiac catheterization performed through the groin within 15 days before operation (p <0.01). Postoperative risk factors were congestive heart failure (p <0.008), prolonged bed rest (p <0.05), and deep vein thrombosis (p <0.03). This study demonstrates that PE is an unusual complication after cardiac operations, has a high mortality rate, and is often related to perioperative immobility and recent groin catheterization. These results also suggest that minimizing preoperative hospital stay may be important in PE prophylaxis.

AB - Pulmonary embolism (PE) is thought to occur infrequently after cardiac operations, possibly because systemic heparinization during cardiopulmonary bypass prevents deep vein thrombosis. This retrospective study was undertaken to determine the actual incidence of PE after cardiac operations and to identify risk factors. Between January 1, 1985, and December 31, 1989, 5,694 adult patients (>18 years old) had open heart operations at the Johns Hopkins Hospital. Thirty-two patients (20 men and 12 women) had PE within 60 days of operation, an overall PE incidence of 0.56%. The diagnosis of PE was established by ventilation/perfusion scan, pulmonary angiogram, or autopsy. Mortality among patients with PE was 34%. Using a case-control method, preoperative and postoperative risk factors for PE were identified by multivariate and multiple logistic regression analyses. Preoperative risk factors included bed rest (p <0.003), prolonged hospitalization before operation (p <0.004), and cardiac catheterization performed through the groin within 15 days before operation (p <0.01). Postoperative risk factors were congestive heart failure (p <0.008), prolonged bed rest (p <0.05), and deep vein thrombosis (p <0.03). This study demonstrates that PE is an unusual complication after cardiac operations, has a high mortality rate, and is often related to perioperative immobility and recent groin catheterization. These results also suggest that minimizing preoperative hospital stay may be important in PE prophylaxis.

UR - http://www.scopus.com/inward/record.url?scp=0026720990&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0026720990&partnerID=8YFLogxK

U2 - 10.1016/0003-4975(92)90372-B

DO - 10.1016/0003-4975(92)90372-B

M3 - Article

C2 - 1596161

AN - SCOPUS:0026720990

VL - 53

SP - 988

EP - 991

JO - Annals of Thoracic Surgery

JF - Annals of Thoracic Surgery

SN - 0003-4975

IS - 6

ER -