Key result
Post-CPB gastrointestinal complications occur in ~1% of cardiac surgery patients with high mortality.
Why the study?
Gastrointestinal complications after cardiac surgery under cardiopulmonary bypass are rare but cause major morbidity and mortality, and risk factors need analysis.
What are the incidence and risk factors for gastrointestinal complications after cardiac surgery under cardiopulmonary bypass?
Cohort (n=13,544)
No
What are the incidence and risk factors for gastrointestinal complications after cardiac surgery under cardiopulmonary bypass?
Gastrointestinal complications after cardiopulmonary bypass are rare (0.94%) but carry high mortality, particularly mesenteric ischemia, and are associated with identifiable high-risk clinical features.
Substantial post-CPB GI mortality, especially mesenteric ischemia, warrants clinical vigilance; leaves open prospective validation of risk factors and prevention.
BACKGROUND: Gastrointestinal (GI) complications are one of the serious complications of cardiac surgery. Although rarely seen, they cause major morbidity and mortality. The aim of the present study was to retrospectively analyze the risk factors acting on the GI complications seen after cardiac operations performed under cardiopulmonary bypass. METHOD: The present study was designed to retrospectively evaluate 13,544 patients who underwent cardiac surgery under cardiopulmonary bypass, between 1988 and 2004 in the authors' clinic. RESULTS: The overall mortality was 346 (2.55%) of 13,544 patients. GI complications developed in 128 patients (0.94%). Among those, 18 (14.1%) died because of GI complications, the most common of which was bleeding. Mesenteric ischemia had the highest case-fatality rate at 71.4%. Valve surgery, concomitant valve and coronary artery bypass grafting surgery, preoperative chronic renal dysfunction, postoperative acute renal failure, deep sternal infection, prolonged ventilation, need for intra-aortic balloon pump and ejection fraction less than 30% were found to be risk factors acting on GI complications. CONCLUSION: GI complications remain a significant concern after cardiac surgery under cardiopulmonary bypass. Higher-risk patients can be identified and treated prophylactically and in the postoperative period.
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Bolcal et al. (2005) conducted a cohort in Cardiac surgery under cardiopulmonary bypass (n=13,544). Cardiac surgery under cardiopulmonary bypass was evaluated on Gastrointestinal complications. Gastrointestinal complications developed in 0.94% of patients after cardiac surgery under cardiopulmonary bypass, carrying a 14.1% mortality rate among affected patients.
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