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

Fabiano F Viana, Yi Chen, Aubrey Anthony Almeida, Heather D Baxter, Andrew Donald Cochrane, Julian Anderson Smith

Research output: Contribution to journalArticleResearchpeer-review

Abstract

BACKGROUND: Gastrointestinal (GI) complications after cardiac surgery are uncommon, but are associated with high morbidity and mortality as well as significant hospital resource utilization. METHODS: We analysed a prospectively collected database containing all adult cardiac surgery procedures performed from July 2001 to March 2011 at Monash Medical Centre and Jessie McPherson Private Hospital. Patients with post-operative GI complications were compared to patients without GI complications who were operated in the same period. RESULTS: The incidence of GI complications was 1.1 (61 out of 5382 patients) with an overall 30-day mortality of 33 (versus 3 in the non-GI complication group). The most common complications were GI bleeding, gastroenteritis and bowel ischaemia. Patients who had GI complications were significantly older, had higher incidence of renal impairment, chronic lung disease and anticoagulation therapy and were more likely to be in cardiogenic shock. Emergency procedures, combined coronary artery bypass grafting and valve surgery and aortic dissection cases were more common in the GI complication group. The GI complication group also had higher incidence of return to theatre, renal failure, stroke, septicaemia and multi-organ failure. CONCLUSIONS: GI complications after cardiac surgery remain an uncommon but dreadful complication associated with high mortality. Our findings should prompt a high degree of clinical vigilance in order to make an early diagnosis especially in high risk patients. Further studies aiming to identify independent predictors for GI complications after cardiac surgery are warranted.
Original languageEnglish
Pages (from-to)651 - 656
Number of pages6
JournalANZ Journal of Surgery
Volume83
Issue number9
DOIs
Publication statusPublished - 2013

Cite this

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title = "Gastrointestinal complications after cardiac surgery: 10-year experience of a single Australian centre",
abstract = "BACKGROUND: Gastrointestinal (GI) complications after cardiac surgery are uncommon, but are associated with high morbidity and mortality as well as significant hospital resource utilization. METHODS: We analysed a prospectively collected database containing all adult cardiac surgery procedures performed from July 2001 to March 2011 at Monash Medical Centre and Jessie McPherson Private Hospital. Patients with post-operative GI complications were compared to patients without GI complications who were operated in the same period. RESULTS: The incidence of GI complications was 1.1 (61 out of 5382 patients) with an overall 30-day mortality of 33 (versus 3 in the non-GI complication group). The most common complications were GI bleeding, gastroenteritis and bowel ischaemia. Patients who had GI complications were significantly older, had higher incidence of renal impairment, chronic lung disease and anticoagulation therapy and were more likely to be in cardiogenic shock. Emergency procedures, combined coronary artery bypass grafting and valve surgery and aortic dissection cases were more common in the GI complication group. The GI complication group also had higher incidence of return to theatre, renal failure, stroke, septicaemia and multi-organ failure. CONCLUSIONS: GI complications after cardiac surgery remain an uncommon but dreadful complication associated with high mortality. Our findings should prompt a high degree of clinical vigilance in order to make an early diagnosis especially in high risk patients. Further studies aiming to identify independent predictors for GI complications after cardiac surgery are warranted.",
author = "Viana, {Fabiano F} and Yi Chen and Almeida, {Aubrey Anthony} and Baxter, {Heather D} and Cochrane, {Andrew Donald} and Smith, {Julian Anderson}",
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Gastrointestinal complications after cardiac surgery: 10-year experience of a single Australian centre. / Viana, Fabiano F; Chen, Yi; Almeida, Aubrey Anthony; Baxter, Heather D; Cochrane, Andrew Donald; Smith, Julian Anderson.

In: ANZ Journal of Surgery, Vol. 83, No. 9, 2013, p. 651 - 656.

Research output: Contribution to journalArticleResearchpeer-review

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AU - Cochrane, Andrew Donald

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N2 - BACKGROUND: Gastrointestinal (GI) complications after cardiac surgery are uncommon, but are associated with high morbidity and mortality as well as significant hospital resource utilization. METHODS: We analysed a prospectively collected database containing all adult cardiac surgery procedures performed from July 2001 to March 2011 at Monash Medical Centre and Jessie McPherson Private Hospital. Patients with post-operative GI complications were compared to patients without GI complications who were operated in the same period. RESULTS: The incidence of GI complications was 1.1 (61 out of 5382 patients) with an overall 30-day mortality of 33 (versus 3 in the non-GI complication group). The most common complications were GI bleeding, gastroenteritis and bowel ischaemia. Patients who had GI complications were significantly older, had higher incidence of renal impairment, chronic lung disease and anticoagulation therapy and were more likely to be in cardiogenic shock. Emergency procedures, combined coronary artery bypass grafting and valve surgery and aortic dissection cases were more common in the GI complication group. The GI complication group also had higher incidence of return to theatre, renal failure, stroke, septicaemia and multi-organ failure. CONCLUSIONS: GI complications after cardiac surgery remain an uncommon but dreadful complication associated with high mortality. Our findings should prompt a high degree of clinical vigilance in order to make an early diagnosis especially in high risk patients. Further studies aiming to identify independent predictors for GI complications after cardiac surgery are warranted.

AB - BACKGROUND: Gastrointestinal (GI) complications after cardiac surgery are uncommon, but are associated with high morbidity and mortality as well as significant hospital resource utilization. METHODS: We analysed a prospectively collected database containing all adult cardiac surgery procedures performed from July 2001 to March 2011 at Monash Medical Centre and Jessie McPherson Private Hospital. Patients with post-operative GI complications were compared to patients without GI complications who were operated in the same period. RESULTS: The incidence of GI complications was 1.1 (61 out of 5382 patients) with an overall 30-day mortality of 33 (versus 3 in the non-GI complication group). The most common complications were GI bleeding, gastroenteritis and bowel ischaemia. Patients who had GI complications were significantly older, had higher incidence of renal impairment, chronic lung disease and anticoagulation therapy and were more likely to be in cardiogenic shock. Emergency procedures, combined coronary artery bypass grafting and valve surgery and aortic dissection cases were more common in the GI complication group. The GI complication group also had higher incidence of return to theatre, renal failure, stroke, septicaemia and multi-organ failure. CONCLUSIONS: GI complications after cardiac surgery remain an uncommon but dreadful complication associated with high mortality. Our findings should prompt a high degree of clinical vigilance in order to make an early diagnosis especially in high risk patients. Further studies aiming to identify independent predictors for GI complications after cardiac surgery are warranted.

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