Postoperative Outcomes of Patients with Chronic Obstructive Pulmonary Disease Undergoing Coronary Artery Bypass Grafting Surgery: A Retrospective Analysis in a High-Volume Single Center

All articles of this category (opens in new window) Background: Chronic obstructive pulmonary disease (COPD) is a frequent comorbidity in patients undergoing coronary artery bypass grafting (CABG) surgery, and recent studies have shown diverse effects on postoperative morbidity and mortality. Therefore, the objective of this study was to analyze the effect of COPD on postoperative outcomes after CABG surgery. Methods: A retrospective data analysis, including all patients who underwent CABG surgery from December 2009 to September 2024, was performed. COPD patients were compared to patients not affected by chronic obstructive lung disease before and after propensity score matching (PSM) on postoperative outcome, including 30-day mortality, hospital length of stay (HLOS), ICU length of stay (ICULOS), and ventilation time (VT). Statistical analysis was performed using RStudio. Results: In total, 5,889 patients were included in the study, of whom 385 (6.5%) suffered from COPD. Before PSM, COPD patients showed a significantly higher 30-day mortality (4.2% vs. 1.4%; p < 0.0001), longer HLOS (11.0 ± 8.5 days vs. 9.4 ± 11.4 days; p = 0.004) and ICULOS (3.9 ± 7.7 days vs. 2.6 ± 4.0 days; p < 0.0001), and showed a significantly longer VT (7 [4.5; 10] hours vs. 6 [4; 8.3] hours; p < 0.0001). However, patients affected by COPD showed a significantly lower preoperative ejection fraction (EF; 51.1 ± 10.7% vs. 53.4 ± 9.3%; p < 0.0001), glomerular filtration rate (GFR; 67.2 ± 22.0 mL/minutes vs. 72.8 ± 19.9 mL/minutes; p < 0.0001), were more likely to be on dialysis (3.4% vs. 1.3%; p = 0.003) and were more likely to be affected by extracardiac atheropathy (34.5% vs. 17.3%, p < 0.0001). After PSM, there was no difference in 30-day mortality rate between the two groups (4.2% vs. 2.3%; p = 0.22), while differences in HLOS (11.0 ± 8.5 days vs. 9.4 ± 5.0 days, p = 0.001), ICULOS (3.9 ± 7.7 days vs. 2.8 ± 3.7 days; p = 0.01) and VT (7 [4.5;10] hours vs. 6 [4;9] hours, p = 0.004) remained significant. Conclusion: COPD patients are more likely to be affected by multiple comorbidities than non-COPD patients and therefore present with a higher 30-day mortality when undergoing CABG surgery. Nevertheless, even after propensity score matching, COPD still negatively affects the outcome after CABG surgery with regard to ventilation time and length of ICU and hospital stay. Publication History Article published online: 17 February 2026 © 2026. Thieme. All rights reserved. Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany