Is the gut safe? Rare postoperative gastrointestinal complications following cardiac surgery

Approximately 1 in 5 patients undergoing cardiac surgery are readmitted within 30 days of discharge. Among the primary causes of readmission are infection and disease states susceptible to the inflammatory cascade, such as diabetes, chronic obstructive pulmonary disease, and gastrointestinal complications. Currently, it is not known if a patient’s baseline inflammatory state measured by crude white blood cell (WBC) counts could predict 30-day readmission. We collected data from 2,176 consecutive patients who underwent cardiac surgery at seven hospitals. Patient readmission data was abstracted from each hospital. The independent association with preoperative WBC count was determined using logistic regression. There were 259 patients readmitted within 30 days, with a median time of readmission of 9 days (IQR 4–16). Patients with elevated WBC count at baseline (10,000–12,000 and >12,000 mm3) had higher 30-day readmission than those with lower levels of WBC count prior to surgery (15% and 18% compared to 10%–12%,P=0.037). Adjusted odds ratios were 1.42 (0.86, 2.34) for WBC counts 10,000–12,000 and 1.81 (1.03, 3.17) for WBC count > 12,000. We conclude that WBC count measured prior to cardiac surgery as a measure of the patient’s inflammatory state could aid clinicians and continuity of care management teams in identifying patients at heightened risk of 30-day readmission after discharge from cardiac surgery.

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Risk factors for gastrointestinal complications after cardiac surgery

Nature Clinical Practice Cardiovascular Medicine ◽

10.1038/ncpgasthep0252x ◽

2005 ◽

Vol 2 (10) ◽

pp. 499-499

Author(s):

Marie Lofthouse

Keyword(s):

Risk Factors ◽

Cardiac Surgery ◽

Gastrointestinal Complications

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Gastrointestinal Complications Following Cardiac Surgery.

Albanian Journal of Trauma and Emergency Surgery ◽

10.32391/ajtes.v3i1.33 ◽

2019 ◽

Vol 3 (1) ◽

Author(s):

Alfred Ibrahimi ◽

Saimir Kuçi ◽

Ervin Bejko ◽

Stavri Llazo ◽

Jonela Burimi ◽

...

Keyword(s):

Risk Factors ◽

Cardiac Surgery ◽

Intestinal Ischemia ◽

Heart Surgery ◽

Open Heart Surgery ◽

Morbidity And Mortality ◽

Gastrointestinal Complication ◽

High Morbidity ◽

Low Cardiac Output Syndrome ◽

Gastrointestinal Complications

Purpose: gastrointestinal complication (GIC) following open heart surgery usually are rare but with high morbidity and mortality. The aim of this study was to see the outcome of these patients after complication, compared with a similar study found in literature. Identifying risk factors preoperatively and postoperatively in our patient’s series, for GIC.Materials and methods: Between January 2012 and December 2017 from 1990 operated cardiac patient 34 of them developed GIC, presenting gastro duodenal bleeding due to active ulcer, liver failure, pancreatitis, cholecystitis, or intestinal ischemia. We performed a retrospective analysis.Results: From all consecutive patient only 1.7 % developed GIC. Mortality rate was 55.8%, especially 100 % mortality in intestinal ischemia patient. Regarding risk factors, those were the same found in other similar study (age, atherosclerosis disease, by pass time, postoperative ARF, Low cardiac output syndrome.)Conclusion: GIC after cardiac surgery are rare but when it happens the mortality is very high not even of late diagnosis. In ages patients, diabetes, long by pass time, long hypoperfusion state. It is recommended to be alert for GIC for detection in early phase, and for reducing as much as possible morbidity and mortality.

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Gastrointestinal complications following cardiac surgery

Asian Cardiovascular and Thoracic Annals ◽

10.1177/0218492320949084 ◽

2020 ◽

Vol 28 (9) ◽

pp. 621-632

Author(s):

Cheryl Yan Ting Chor ◽

Saira Mahmood ◽

Inayat Hussain Khan ◽

Manasi Shirke ◽

Amer Harky

Keyword(s):

Risk Factors ◽

Cardiac Surgery ◽

Preventive Measures ◽

Signs And Symptoms ◽

Mortality Rates ◽

Gastrointestinal Complication ◽

Gastrointestinal Complications ◽

Ischemic Bowel ◽

Preventative Measures ◽

Life Threatening

Gastrointestinal complications after cardiac surgery may be uncommon but they carry high mortality rates. Incidences range from 0.5% to 5.5%, while mortality rates of such complications vary from 0.3% to 87%. They range from small gastrointestinal bleeds, ileus, and pancreatitis to life-threatening complications such as liver failure and ischemic bowel. Due to the vague and often absence of specific signs and symptoms, diagnosis of a gastrointestinal complication is often late. This article aims to review and summarize the literature concerning gastrointestinal complications after cardiac surgery. We discuss the causes, risk factors, diagnosis, preventative measures, and management of these complications. In general, risk factor identification, preventive measures, early diagnosis, and swift management are the keys to reducing the occurrence of gastrointestinal complications and their associated morbidity and mortality.

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