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Published on: May 18, 2018
Outcome and survival analysis of intestinal ischaemia following cardiac surgery
Philip Y K Pang1, Yoong Kong Sin, Chong Hee Lim
1Department of Cardiothoracic Surgery, National Heart Centre, Singapore, Singapore.
Objectives:
Intestinal ischaemia is an uncommon (<1%) but serious complication of cardiac surgery with a mortality rate exceeding 50%. Diagnosis of this potentially lethal condition can be difficult and requires a high index of suspicion. The purpose of this study was to analyse the outcomes and prognostic factors in patients who develop intestinal ischaemia following cardiac surgery.
Methods:
In a retrospective review from August 1999 to December 2010, we identified 31 out of 9925 (0.31%) consecutive patients who developed acute intestinal ischaemia following cardiac surgery at our tertiary centre.
Results:
The overall mortality was 71.0%. The operative mortality was 65.4% in patients who underwent a laparotomy. Survivors of this complication had surgical intervention earlier (7.4 ± 4.9 h) compared with the non-survivors (13.9 ± 11.1 h). A total of 35 perioperative variables were analysed. A univariate analysis identified 12 variables associated with an increased risk of mortality. Logistic multivariate analysis identified the preoperative logistic EuroSCORE and the base excess at the point of diagnosis of intestinal ischaemia as significant predictors of mortality. These factors may aid prognostication in this group of patients.
Conclusions:
Despite the high mortality rates associated with intestinal ischaemia following cardiac surgery, early diagnosis and surgical intervention remain the only effective means to reduce mortality.
