Key result
Acute mesenteric ischemia after cardiac surgery was associated with significantly higher in-hospital mortality (p<0.001), and lactic acid >2 mmol/L with opioids independently predicted AMI (p=0.025).
Why the study?
Acute mesenteric ischemia is associated with poor outcomes after cardiac surgery, prompting analysis of its influence on short-term outcomes, in-hospital mortality risk factors, and the role of opioids and lactic acid.
Do opioids and lactic acid levels predict acute mesenteric ischemia and in-hospital mortality in patients with gastrointestinal complications after cardiac surgery?
Cohort (n=176)
Do opioids and lactic acid levels predict acute mesenteric ischemia and in-hospital mortality in patients with gastrointestinal complications after cardiac surgery?
p-value: p=<0.001
Prolonged opioid treatment and sudden lactic acid increase are independent predictors of acute mesenteric ischemia in patients with gastrointestinal complications after cardiac surgery.
May support heightened suspicion for mesenteric ischemia in post-cardiac surgery GI complications; hypothesis-generating pending prospective validation.
Acute mesenteric ischemia (AMI) is associated with poor clinical results after cardiac surgery. The aim of this study was to analyse the influence of AMI on short-term outcomes and all relevant risk factors of in-hospital mortality after cardiac surgery. Moreover, we aimed to investigate the role of opioids and lactic acid in the detection and prevention of AMI. Between August 2011 and September 2015, 176 consecutive patients with gastrointestinal complications after undergoing open-heart surgery were identified and included in this study. All patients were divided into two groups: AMI group (n = 39) and non-AMI group (n = 137). In terms of comorbidities, the groups were fairly equal and showed no significant differences. Dialysis was significantly higher (p < 0.001) in patients that suffered from AMI. Moreover, gastro-intestinal symptoms such as muscular defense (p = 0.004) and the laparotomy rate (p < 0.001) were significantly higher in the AMI group. Likewise, in-hospital mortality (p < 0.001) was significantly higher in patients with detected AMI. Univariate (p < 0.001) and multivariate analysis (p = 0.025) of both groups revealed that lactic acid value >2 mmol/L and present treatment with opioids are independent combined predictors of mesenteric ischemia in patients after undergoing cardiac surgery. Moreover, multivariate analysis showed peripheral vascular disease (p = 0.004), dialysis (p = 0.010), and septic shock (p = 0.003) as relevant predictors of in-hospital mortality. Prolonged analgetic treatment with opioids and sudden increase of lactic acid levels are independent combined predictors of mesenteric ischemia in patients after undergoing cardiac surgery. Furthermore, peripheral vascular disease, dialysis, and septic shock are relevant predictors for in-hospital mortality.
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Krasivskyi et al. (2023) conducted a cohort in Acute mesenteric ischemia after cardiac surgery (n=176). Acute mesenteric ischemia (AMI) vs. Non-AMI was evaluated on In-hospital mortality (p=<0.001). Acute mesenteric ischemia after cardiac surgery was associated with significantly higher in-hospital mortality (p<0.001), and lactic acid >2 mmol/L with opioids independently predicted AMI (p=0.025).
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