Outcome and survival analysis of intestinal ischaemia following cardiac surgery

Pang, Philip Y.K.; Sin, Yoong Kong; Lim, Chong Hee; Su, Jang Wen; Chua, Yeow Leng

doi:10.1093/icvts/ivs181

Cited by 17 publications

(15 citation statements)

References 12 publications

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“…found that survivors of this complication had surgical intervention earlier compared to the non‐survivors. Prompt treatment is the only hope to reduce the high mortality rate associated with this GI complication …”

Section: Discussionmentioning

confidence: 99%

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Gastrointestinal complications after cardiac surgery: 10-year experience of a single Australian centre

et al. 2013

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Section: Discussionmentioning

confidence: 99%

“…Prompt treatment is the only hope to reduce the high mortality rate associated with this GI complication. 25 The reported incidence of perforated duodenal or gastric ulcer post-cardiac surgery is approximately 6% of all GI complications. This is associated with 38% mortality.…”

Section: Discussionmentioning

confidence: 99%

Gastrointestinal complications after cardiac surgery: 10-year experience of a single Australian centre

et al. 2013

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“…In some studies, survivors of this complication have had surgical intervention earlier [5,11]. However, early laparotomies do not necessarily mean survival in cases of extensive ischemia [23].…”

Section: Discussionmentioning

confidence: 99%

Intestinal ischemia after cardiac surgery: analysis of a large registry

Nilsson

Hansson

Andersson

2013

J Cardiothorac Surg

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BackgroundIntestinal ischemia after cardiac surgery is a rare but severe complication with a high mortality. Early surgery can be lifesaving. The aim was to analyze the incidence, outcome, and risk factors for these patients.MethodsA prospectively collected database with patients who underwent 18,879 cardiac surgical procedures between 1996 and 2011 was investigated. All patients with registered gastrointestinal complications were retrospectively reviewed. Univariate and multivariate analyses were performed to compare patients with and without intestinal ischemia.ResultsSeventeen patients suffered from intestinal ischemia (0.09%), 10 of whom (59%) died. By investigating preoperative parameters independent risk factors were steroids, peripheral vascular disease, cardiogenic shock, and New York Heart Association class 4. When including pre-, per-, and postoperative parameters, only postoperative ones were significant, including elevated creatinine (> 200 μmol/L), prolonged ventilator time, need for intra-aortic balloon pump, and cerebrovascular insult (CVI). The gastrointestinal complications score (GICS) showed a ROC area of 0.87. This was superior compared with EuroSCORE (0.74), to predict intestinal ischemia.ConclusionsIntestinal ischemia after cardiac surgery is more common in patients with a poor cardiac state, but the use of steroids, peripheral vascular disease, postoperative kidney failure, and CVI were also predictive. GICS score, developed for all GI complications after cardiac surgery, is also of value in predicting this particular complication. The risk factors presented can be used as an aid in the diagnosis of these patients.

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“…There are many demographic and surgical variables seen as risk factors for intestinal ischemia after CPB, such as arterial hypotension, postoperative heart failure, renal insufficiency, age >70 years, hypovolemia, cardiopulmonary bypass time >150 min, New York Heart Association (NYHA) class III-IV, active smoker, sepsis, IABP support, use of vasopressors, and preexisting atherosclerotic lesions [ 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

Acute Mesenteric Ischemia after Cardiac Surgery: An Analysis of 52 Patients

Eris

Yavuz

Yalcinkaya

et al. 2013

The Scientific World Journal

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Objective. Acute mesenteric ischemia (AMI) is a rare but serious complication after cardiac surgery. The aim of this retrospective study was to evaluate the incidence, outcome, and perioperative risk factors of AMI in the patients undergoing elective cardiac surgery. Methods. From January 2005 to May 2013, all patients who underwent cardiac surgery were screened for participation, and patients with registered gastrointestinal complications were retrospectively reviewed. Univariate analyses were performed. Results. The study included 6013 patients, of which 52 (0.86%) patients suffered from AMI, 35 (67%) of whom died. The control group (150 patients) was randomly chosen from among cases undergoing cardiopulmonary bypass (CPB). Preoperative parameters including age (P = 0.03), renal insufficiency (P = 0.004), peripheral vascular disease (P = 0.04), preoperative inotropic support (P < 0.001), poor left ventricular ejection fraction (P = 0.002), cardiogenic shock (P = 0.003), and preoperative intra-aortic balloon pump (IABP) support (P = 0.05) revealed significantly higher levels in the AMI group. Among intra- and postoperative parameters, CPB time (P < 0.001), dialysis (P = 0.04), inotropic support (P = 0.007), prolonged ventilator time (P < 0.001), and IABP support (P = 0.007) appeared significantly higher in the AMI group than the control group. Conclusions. Prompt diagnosis and early treatment should be initiated as early as possible in any patient suspected of AMI, leading to dramatic reduction in the mortality rate.

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Outcome and survival analysis of intestinal ischaemia following cardiac surgery

Abstract: 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.

Cited by 17 publications

References 12 publications

Gastrointestinal complications after cardiac surgery: 10-year experience of a single Australian centre

Gastrointestinal complications after cardiac surgery: 10-year experience of a single Australian centre

Intestinal ischemia after cardiac surgery: analysis of a large registry

Acute Mesenteric Ischemia after Cardiac Surgery: An Analysis of 52 Patients

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