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Published on: November 10, 2018
Predictors and outcomes of gastrointestinal complications in patients undergoing coronary artery bypass graft
Matthew H Recht1, J Michael Smith, Scott E Woods
1Department of Surgery, Good Samaritan Hospital, Hatton Research 11-J, 375 Dixmyth Avenue, Cincinnati, OH 45220, USA.
Insights
Older age, dialysis, and urgent procedures significantly increase gastrointestinal complication risk in coronary artery bypass graft (CABG) patients. These patients also face higher mortality and more negative outcomes.
Area of Science:
- Cardiovascular Surgery
- Gastrointestinal Complications
- Patient Outcomes
Background:
- Gastrointestinal (GI) complications are a concern in patients undergoing coronary artery bypass graft (CABG) surgery.
- Identifying risk factors and outcomes associated with GI complications is crucial for improving patient care.
Purpose of the Study:
- To assess the risk factors associated with developing GI complications after CABG.
- To evaluate the outcomes for patients who experience GI complications post-CABG.
Main Methods:
- A nested case-control study was conducted using a 9-year hospitalization cohort (n=7,345).
- 66 patients with GI complications (cases) were matched 1:5 to 330 patients without complications (controls).
- 16 risk factors and 14 outcomes were examined.
Main Results:
- Significant risk factors for GI complications included age over 70, dialysis, and urgent procedure status.
- Patients with GI complications had increased mortality, required more procedures, and experienced higher rates of arrhythmia, neurologic, pulmonary, renal, and sternal wound issues.
- Increased length of hospital stay, ICU stay, ventilator time, and postoperative creatine phosphokinase levels were observed in patients with GI complications.
Conclusions:
- Urgency of the procedure, age >70 years, and dialysis are significant predictors of GI complications in CABG patients.
- GI complications are associated with substantially worse patient outcomes, including increased mortality and morbidity.
Background:
The aim of this study was to assess risk factors and outcomes of gastrointestinal (GI) complications in patients undergoing coronary artery bypass surgery (CABG).
Study Design:
We conducted a nested case-control study from a 9-year hospitalization cohort (n = 7,345) in which data were collected prospectively. Patients developed GI complications (n = 66) and controls did not (n = 330). Cases were matched to controls 1:5 on type of surgery. We examined 16 risk factors and 14 outcomes.
Results:
Five risk factors proved significant in predicting GI complications. Patients were more likely to be older than age 70, to be on dialysis, to have left ventricular hypertrophy, and to be on anticoagulants; the procedure was also more likely to be urgent. There was no significant difference between the cases and controls for the remaining 11 risk factors. We also computed correlation coefficients among the significant variables; using regression analysis, we found that patients undergoing CABG had a threefold increase in the risk of GI complications if they were older than age 70 (odds ratio [OR] 1.06, 95% CI 1.03 to 0.97), if they were on dialysis (OR 1.87, 95% CI 1.98 to 1.22), and if their procedure was urgent (OR 1.91, 95% CI 1.07 to 3.4). Eleven outcomes proved significant. Patients with GI complications ran a greater risk of mortality; required more additional procedures; suffered arrhythmia that required treatment; and were more likely to have neurologic, pulmonary, renal, and sternal wound complications. They also had greater length of hospitalization, intensive care unit length of hospitalization, ventilator time, and postoperative creatine phosphokinase levels.
Conclusions:
In patients undergoing CABG surgery, urgency of the procedure, age greater than 70 years, and dialysis all significantly increased the risk of a GI complication. Patients with GI complications also experienced more negative outcomes.
