Gastrointestinal complications after cardiac surgery: Incidence, predictors, and impact on outcomes

Abstract

Background The purpose of this study was to investigate the incidence, predictors, and long‐term impact of gastrointestinal (GI) complications following adult cardiac surgery. Methods Index Society of Thoracic Surgeons (STS) adult cardiac operations performed between January 2010 and February 2018 at a single institution were included. Patients were stratified by the occurrence of postoperative GI complications. Outcomes included early and late survival as well as other associated major postoperative complications. A subanalysis of propensity score‐matched patients was also performed. Results A total of 10,285 patients were included, and the overall rate of GI complications was 2.4% (n = 246). Predictors of GI complications included dialysis dependency, intra‐aortic balloon pump, congestive heart failure, chronic obstructive pulmonary disease, and longer aortic cross‐clamp times. Thirty‐day (2.6% vs. 24.8%), 1‐ (6.3% vs. 41.9%), and 3‐year (11.1% vs. 48.4%) mortality were substantially higher in patients who experienced GI complications (all p < .001). GI complication was associated with a threefold increased hazard for mortality (hazard ratio = 3.1, 95% confidence interval = 2.6–3.7) after risk adjustment, and there was an association between the occurrence of GI complications and increased rates of renal failure (39.4% vs. 2.5%), new dialysis dependency (31.3% vs. 1.5%), multisystem organ failure (21.5% vs .1.0%), and deep sternal wound infections (2.6% vs. 0.2%; all p < .001). These results persisted in propensity‐matched analysis. Conclusion GI complications are infrequent but have a profound impact on early and late survival, and often occur in association with other major complications. Risk factor modification, heightened awareness, and early detection and management of GI complications appear warranted.

Hepatic and gastrointestinal complications after adult cardiac surgery

“…Gulkarov and coworkers [10] reported that chronic renal failure (CRF) was an independent determinant for GIT complications in 18% of patients who had GIT complications. Hess and associates [18] revealed a considerable increase in mortality and morbidity when GIT issues arise. Those with gastrointestinal issues had a mortality rate of 24.8% in the first 30 days.…”

Letter To The Editor: Gastrointestinal complications after cardiac surgery: Incidence, predictors, and impact on outcomes

“…Dear Editor, We have recently reviewed the article with substantial attentiveness entitled "Gastrointestinal complications after cardiac surgery: Incidence, predictors, and impact on outcomes" by Nicholas R. Hess et Al. 1 The complications following cardiac surgery are well portrayed in this study. The author's work on this crucial topic is highly appreciated and applauded by the readers.…”

Predictors and outcomes of gastrointestinal complications after cardiac surgery: A systematic review and meta-analysis

“…Acute renal failure, new-onset AF, myocardial infarction, stroke, and sepsis were statistically significantly more frequent in patients with GICs in the postoperative period. The length of hospital stay of patients with GIC was statistically significantly longer than that of Age (year) [2,5,8,9,[12][13][14][15][16][17]19,21,22,24,25] 4.88 Female [2][3][4][5][6][7][8][9][11][12][13][14][15][16][17][18][19][20][21][23][24][25] 0.91 Hypertension [3,5,[7][8][9]11,12,[14][15][16][18][19]…”