• Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai 200030, P.R. China.2. Department of Intensive Care Unit, Shanghai Chest Hospital, Shanghai 200030, P. R. China;;
  • 3. Department of Anesthesiology, Shanghai Chest Hospital, Shanghai 200030, P. R. China;
Old age; Thoracotomy; Respiration; Circulation; Complication
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Objective To investigate the causes and prevention of cardiopulmonary complications in elderly patients after thoracotomy. Methods Respiratory and circulatory status were monitored and postoperative complications were documented in 58 elderly patients either aged over 65 years, with major organ dysfunction or underwent highly invasive procedures （experimental group） during July 2001 to Dec. 2003. The results were compared with those from 56 young patients（〈65 years） receiving thoracotomy in the same period （control group）. Results Patients in experimental group had significantly more preoperative cardiopulmonary co-morbidities and poorer spirometry than those in control group （P〈0.05）. Four patients died after operation in experimental group. There were significantly more postoperative complications in experimental group than those in control group [58. 6% （34/58） vs. 17. 9% （10/56）, P=0. 000], especially functional complications [51.7% （30/58） vs. 12.5% （7/56）, P = 0. 000]. The rate of respiratory complications was also significantly higher in the experimental group . Multivariance logistic regression showed that preoperative pulmonary morbidity （OR=5.4） and obesity （OR=4. 9） were independent risk factors for pulmonary complications after thoracotomy in elderly patients. Conclusions Cardiopulmonary co-morbidities commonly seen are responsible for surgical morbidities, especially the functional complications in elderly patients underwent thoracotomy. Respiratory complications are the major causes of death in the elderly after thoracotomy. Pulmonary co-morbidity and obesity are independent risk factors for respiratory complications. Supraventricular tachycardia is the major type of cardiovascular complications after thoracotomy and is predicted by preoperative cardiovascular morbidity. Close monitoring of cardiopulmonary status of the elderly may identify patients at risk in developing functional complications and help improve surgical outcome.

Citation： FANG Wentao,CHEN Yong,ZHANG Xiangyu,et al. Analysis of the Causes of Cardiopulmonary Complications in Elderly Patients after Thoracotomy. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2006, 13(4): 233-237. doi: Copy