Long-Term Mortality After Pneumonia in Cardiac Surgery Patients: A Propensity-Matched Analysis

Area of Science:

• Cardiology
• Critical Care Medicine
• Infectious Diseases

Background:

• The long-term impact of intensive care unit (ICU)-acquired pneumonia on cardiac surgery patients remains unclear.
• This study investigated the association between pneumonia and both in-hospital and long-term mortality in adult cardiac surgery survivors.

Purpose of the Study:

• To examine the relationship between ICU-acquired pneumonia and mortality outcomes in adult cardiac surgery patients.
• To identify pneumonia as a predictor of hospital mortality and long-term survival.

Main Methods:

• An observational study of 2750 adult cardiac surgery patients admitted to the ICU between 2003 and 2009.
• Patients with ICU-acquired pneumonia were matched 1:2 with controls based on age, surgery type, procedure, and propensity score.
• Statistical analyses included multiple regression for hospital mortality and Cox proportional regression for long-term survival.

Main Results:

• Pneumonia occurred in 1.2% of patients (19 cases per 1000 ventilation days).
• Patients with pneumonia had significantly higher hospital mortality (28% vs. 6.2%) and end-of-follow-up mortality (53% vs. 19%).
• Pneumonia was a strong predictor of hospital mortality, and Cox analysis revealed significantly poorer long-term survival (HR=3.96).

Conclusions:

• ICU-acquired pneumonia is a serious complication following cardiac surgery.
• Pneumonia is associated with increased hospital mortality and substantially reduced long-term survival in this patient population.