Association between postoperative acute hypoxaemic respiratory failure and hospital mortality in patients undergoing cardiac surgery: A multicenter registry-based retrospective study - 17/03/26
, Ryan Ruiyang Ling d, e, f, Samad Raza g, David Pilcher d, h, i, Kiran Shekar j, k, l, mAbstract |
Objective |
Acute hypoxemic respiratory failure (AHRF) is a common complication after cardiac surgery, but its prognostic significance for hospital mortality remains inadequately defined. We aimed to determine the association between early AHRF and hospital mortality following cardiac surgery.
Methods |
In this retrospective multicenter cohort study, we used data from the Australian and New Zealand Intensive Care Society Adult Patient Database. All adult patients (aged ≥ 16 years) admitted to an ICU following coronary artery bypass grafting (CABG), valvular surgery, or combined procedures between January 2018 and December 2022 were included. AHRF was defined as a PaO 2 /FiO 2 ratio < 300 mmHg during the ICU admission. The primary outcome was hospital mortality. Secondary outcomes included ICU mortality and ICU and hospital length of stay. A nested hierarchical multivariable logistic regression model was used to assess the association between PaO 2 /FiO 2 ratio and hospital mortality.
Results |
Among 86,214 included patients, 62.7% (n = 54,044) had AHRF. Overall hospital mortality was low (1.1%), but significantly higher in patients with AHRF (1.4% vs. 0.8%; p < 0.001). AHRF was independently associated with increased hospital mortality (adjusted odds ratio = 1.56; 95%CI, 1.33−1.82). A non-linear relationship was observed between PaO 2 /FiO 2 ratio and hospital mortality, with a sharp rise in mortality below a threshold of approximately 200 mmHg.
Conclusions |
In this large cohort of cardiac surgery patients, AHRF was common and significantly associated with increased hospital mortality. A non-linear inflection in risk below a PaO 2 /FiO 2 ratio of 200 mmHg suggests the importance of early recognition and targeted respiratory support in the postoperative period.
Le texte complet de cet article est disponible en PDF.Keywords : Acute hypoxemic respiratory failure, AHRF, Cardiac surgery, PaO 2 /FiO 2 ratio , ANZICS adult patient database, Mortality
Plan
Vol 45 - N° 3
Article 101659- mai 2026 Retour au numéro
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