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Gastrointestinal bleeding following pediatric cardiac bypass: An insight from the national inpatient sample
Kirellos Said Abbas1, Ahmed Abu-Zaid2, Adnan I Qureshi3
1Department of Pediatric, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
Background:
Gastrointestinal (GI) bleeding is a rare but severe complication following pediatric cardiac bypass surgery. Despite advancements in pediatric cardiac surgery, postoperative complications like GI bleeding remain a critical concern. This study investigates its incidence, risk factors, and outcomes using the National Inpatient Sample (NIS).
Methods:
A retrospective, cross-sectional analysis was conducted using the NIS database (2016-2020). Pediatric patients (0-18 years) undergoing cardiac bypass surgery were identified via International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD-10-PCS) codes, with postoperative GI bleeding defined by ICD-10-CM diagnosis codes. Weighted analyses accounted for the complex survey design, and multivariable logistic regression identified independent predictors.
Results:
Among 24,275 weighted cases, 110 (0.45%) experienced postoperative gastrointestinal (GI) bleeding. Significant predictors included cardiac surgery (OR = 5.7, 95% CI: 3.75-8.69, P < 0.001), larger hospital bed size, and teaching hospital status. Calendar year and hospital region were also associated with bleeding risk (95.5% of cases). Mortality was significantly higher in patients with GI bleeding (36.4% vs. 0.3%, P < 0.001).
Conclusions:
Postoperative GI bleeding is a life-threatening complication in pediatric cardiac bypass surgery. Identifying high-risk patients and optimizing perioperative management are crucial. Future research should focus on elucidating underlying mechanisms and developing targeted interventions to improve outcomes.
