Incidence and risk factors of acute cholecystitis after cardiovascular surgery

2021 ◽  
Author(s):  
Jun Kamei ◽  
Akira Kuriyama ◽  
Takeshi Shimamoto ◽  
Tatsuhiko Komiya
Keyword(s):  
Risk Factors ◽  
Acute Cholecystitis ◽  
Cardiovascular Surgery

Acute gastrointestinal complications after cardiac surgery

1996 ◽  
Vol 5 (2) ◽  
pp. 109-118 ◽  
Author(s):  
MA Halm
Keyword(s):  
Risk Factors ◽  
Gastrointestinal Bleeding ◽  
Acute Cholecystitis ◽  
Intestinal Ischemia ◽  
Hepatic Dysfunction ◽  
Cardiovascular Surgery ◽  
Early Recognition ◽  
Clinical Manifestations ◽  
Gastrointestinal Complications ◽  
Gastrointestinal Problems

Gastrointestinal problems, with an incidence of about 1%, may complicate the postoperative period after cardiovascular surgery, increasing morbidity, length of stay, and mortality. Several risk factors for the development of these complications, including preexisting conditions; advancing age; surgical procedure, especially valve, combined bypass/valve, emergency, reoperative, and aortic dissection repair; iatrogenic conditions; stress; ischemia; and postpump complications, have been identified in multiple research studies. Ischemia is the most significant of these risk factors after cardiovascular surgery. Mechanisms that have been implicated include longer cardiopulmonary bypass and aortic cross-clamp times and hypoperfusion states, especially if inotropic or intra-aortic balloon pump support is required. These risk factors have been linked to upper and lower gastrointestinal bleeding, paralytic ileus, intestinal ischemia, acute diverticulitis, acute cholecystitis, hepatic dysfunction, hyperamylasemia, and acute pancreatitis. Gastrointestinal bleeding accounts for almost half of all complications, followed by hepatic dysfunction, intestinal ischemia, and acute cholecystitis. Identification of these gastrointestinal complications may be difficult because manifestations may be masked by postoperative analgesia or not reported by patients because they are sedated or require prolonged mechanical ventilation. Furthermore, clinical manifestations may be nonspecific and not follow the "classic" clinical picture. Therefore, astute assessment skills are needed to recognize these problems in high-risk patients early in their clinical course. Such early recognition will prompt aggressive medical and/or surgical management and therefore improve patient outcomes for the cardiovascular surgical population.

Risk factors for surgical site infections after pediatric cardiovascular surgery

2004 ◽  
Vol 23 (3) ◽  
pp. 231-234 ◽  
Author(s):  
AMANDA L. ALLPRESS ◽  
GEOFFREY L. ROSENTHAL ◽  
KATHY M. GOODRICH ◽  
FLAVIAN M. LUPINETTI ◽  
DANIELLE M. ZERR
Keyword(s):  
Risk Factors ◽  
Cardiovascular Surgery ◽  
Surgical Site Infections ◽  
Pediatric Cardiovascular Surgery

Clinical characteristics and management of acute cholecystitis after cardiovascular surgery

2020 ◽  
Author(s):  
Koya Yasukawa ◽  
Akira Shimizu ◽  
Koji Kubota ◽  
Tsuyoshi Notake ◽  
Shinsuke Sugenoya ◽  
...  
Keyword(s):  
Acute Cholecystitis ◽  
Clinical Characteristics ◽  
Cardiovascular Surgery

scholarly journals Cost analysis and evaluation of risk factors for postoperative pneumonia after thoracic and cardiovascular surgery: a single-center study

2019 ◽  
Vol 4 (2) ◽  
pp. 56
Author(s):  
Aysegul Inci Sezen ◽  
Celal Bugra Sezen ◽  
Sevgi Sokulmez Yildirim ◽  
Murat Dizbay ◽  
Fatma Ulutan
Keyword(s):  
Risk Factors ◽  
Cost Analysis ◽  
Cardiovascular Surgery ◽  
Postoperative Pneumonia ◽  
Single Center ◽  
Analysis And Evaluation ◽  
Single Center Study ◽  
Center Study

Case-Control Study of Risk Factors for Mediastinitis After Cardiovascular Surgery

2006 ◽  
Vol 27 (12) ◽  
pp. 1397-1400 ◽  
Author(s):  
M. J. López Gude ◽  
R. San Juan ◽  
J. M. Aguado ◽  
L. Maroto ◽  
F. López-Medrano ◽  
...  
Keyword(s):  
Risk Factors ◽  
Case Control Study ◽  
Cardiovascular Surgery ◽  
Case Control ◽  
Multivariate Logistic Regression Model ◽  
Chronic Obstructive ◽  
Multivariate Logistic Regression ◽  
Obstructive Pulmonary Disease ◽  
Independent Risk Factors ◽  
Control Study

We report results of a case-control study in which we evaluated 41 risk factors potentially associated with the development of post-surgical mediastinitis. There were 163 case patients and 326 control patients. Independent risk factors kept in the final multivariate logistic regression model were obesity (defined as a body mass index of greater than 30), diabetes mellitus, chronic obstructive pulmonary disease, preoperative stay longer than 1 week, pulmonary hypertension, perioperative myocardial infarction, and reoperation.

scholarly journals Risk factors for infection after cardiovascular surgery in children in Argentina

2009 ◽  
Vol 13 (6) ◽  
pp. 414-416 ◽  
Author(s):  
Maria Teresa Rosanova ◽  
Adrian Allaria ◽  
Alejandro Santillan ◽  
Claudia Hernandez ◽  
Luis Landry ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Surgery

Acute Cholecystitis Occurs More Commonly Than Expected Following Allogeneic Hematopoietic Stem Cell Transplantation and Is Ineffectively Diagnosed Using Abdominal Ultrasound

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 2046-2046
Author(s):  
Stephen J. Bagley ◽  
Alison R. Sehgal ◽  
Noelle V. Frey ◽  
Saar Gill ◽  
Elizabeth Hexner ◽  
...  
Keyword(s):  
Risk Factors ◽  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Acute Cholecystitis ◽  
Case Control Study ◽  
Case Control ◽  
First Year ◽  
Hematopoietic Stem ◽  
Control Study

Abstract Background Having observed an unexpectedly high rate of acute cholecystitis following allogeneic hematopoietic stem cell transplantation (allo-HCT), we sought to define the risk factors for development of acute cholecystitis following allo-HCT, as well as the incidence, radiographic presentation, and outcomes of this disease in the transplant population. Methods Between January 2001 and December 2011, 644 patients underwent allo-HCT at our institution. Using ICD-9 codes, we screened this population for a diagnosis of acute cholecystitis or for cholecystectomy in the first year following HCT. Cases were confirmed through manual chart review, and were defined as having one or more imaging modalities positive for acute cholecystitis or having surgical gallbladder pathology consistent with acute cholecystitis. We then conducted a nested case-control study with controls randomly selected through incidence density sampling of the transplant cohort at a rate of 3:1, matching for age and sex. Using logistic regression, we evaluated multiple potential risk factors for the development of acute cholecystitis, including underlying hematologic malignancy, graft-versus-host-disease (GVHD), total parenteral nutrition (TPN) use, graft source, ABO incompatibility, >10% weight loss, conditioning regimen, and cytomegalovirus reactivation. Finally, we conducted a separate case-control study to evaluate the effectiveness of multiple radiographic studies in the diagnosis of acute cholecystitis in HCT recipients (n=32) compared to randomly selected non-transplant control patients who were diagnosed with acute cholecystitis at our institution (n=96). Results The incidence of acute cholecystitis in the first year of transplant was 5.0% (32/644 patients). Of the 32 patients, 21 (65.6%) were male and 11 (34.4%) were female with a median age of 52.2 years (range, 24–75 years). Median time from HCT to diagnosis of acute cholecystitis was 56.5 days (range, 6–342 days). Twenty of 32 patients (62.5%) were treated with cholecystectomy, 7 (21.9%) with percutaneous cholecystostomy drainage, and the remaining 5 (15.6%) with conservative medical management. Twenty of the 32 patients who developed acute cholecystitis died within one year of HCT (62.5%), compared with 19 of 96 control patients (19.8%), (p<0.001). Of the 20 cholecystitis patients who died, three (15%) died as a direct result of acute cholecystitis; cause of death was septic shock in all 3 cases. HCT patients who received TPN had a higher risk of developing acute cholecystitis (multivariate OR, 3.41; p=0.009), while development of GVHD was protective against developing acute cholecystitis (multivariate OR, 0.28; p=0.006). When accounting only for development of grade III-IV GVHD, a trend towards protection remained but was not statistically significant (OR, 0.24; p=0.061). Ultrasound findings were equivocal for acute cholecystitis (vs. definitively positive or negative) more frequently in allo-HCT patients than in non-HCT patients (50.0% vs. 30.6%), although this difference was not statistically significant (p=0.063). Of the 32 case patients, 30 (93.8%) had US performed, and of these only 13 (43.3%) had an US positive for acute cholecystitis. Computed tomography (CT) scan was equivocal (versus definitively positive or negative) for acute cholecystitis at similar rates in allo-HCT and non-HCT patients (54.7%, vs. 41.2%, p=0.331), and cholescintigraphy (HIDA) scan was positive for cholecystitis at similar rates in both populations (80.0% vs. 77.4%, p=0.82). Conclusions Acute cholecystitis is a common complication of allo-HCT, especially in patients who received TPN. It is associated with a high 1-year mortality rate, and abdominal US has suboptimal performance in diagnosing it. Our data suggest that a high index of suspicion and use of alternative imaging modalities are required to make a prompt diagnosis and may improve the outcomes of allo-HCT patients. Disclosures: No relevant conflicts of interest to declare.

Analysis of the perioperative change in cognitive function of patients with risk factors for cognitive impairment in cardiovascular surgery

2018 ◽  
Vol 67 (2) ◽  
pp. 214-218 ◽  
Author(s):  
Akihiro Yoshimoto ◽  
Takafumi Inoue ◽  
Sei Morizumi ◽  
Satoshi Nishi ◽  
Takaharu Shimizu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Cardiovascular Surgery
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