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Predictors and outcome of gastrointestinal complications in patients undergoing cardiac surgery

Farzan Filsoufi1, Parwis B Rahmanian, Javier G Castillo

  • 1Department of Cardiothoracic Surgery, Mount Sinai School of Medicine, New York, NY 10029, USA. farzan.filsoufi@mountsinai.org

Annals of Surgery
|August 2, 2007
PubMed

Insights

Gastrointestinal complications following cardiac surgery are rare (<1%), but associated with increased mortality. Identifying high-risk patients and implementing preventive measures are crucial for better outcomes.

Area of Science:

  • Cardiology
  • Gastroenterology
  • Surgical Outcomes

Background:

  • Gastrointestinal complications (GICs) like ischemia and hemorrhage are rare but severe after cardiac surgery.
  • Evolving patient profiles necessitate re-evaluation of GIC incidence and risk factors.

Purpose of the Study:

  • To determine the incidence of GICs after cardiac surgery.
  • To identify independent predictors of GICs in this patient population.

Main Methods:

  • Retrospective analysis of prospectively collected data from 4819 cardiac surgery patients (1998-2004).
  • Comparison of patients with GICs to the general patient population.
  • Multivariate analysis to identify independent predictors of GICs.

Main Results:

  • GICs occurred in 1.1% of patients, primarily intestinal ischemia (59%) and hemorrhage (41%).
  • Incidence decreased over the study period and varied by procedure type (e.g., CABG/valve highest, CABG lowest).
  • Independent predictors included advanced age, myocardial infarction, CHF, hemodynamic instability, prolonged bypass time, PVD, renal, and hepatic failure.

Conclusions:

  • Gastrointestinal complications after cardiac surgery are infrequent (<1%) in contemporary series.
  • Preventive measures and intraoperative advancements are key to reducing GIC incidence.
  • Identifying high-risk patients allows for targeted perioperative monitoring to mitigate GICs.
Abstract

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