In this study, doctors from the United States assessed risks and outcomes of gastrointestinal (GI) complications in patients undergoing coronary artery bypass surgery (CABG).
The team conducted a nested case-control study from a 9-year hospitalization cohort of 7345 patients. Data were collected prospectively.
There were 66 cases who developed GI complications, and 330 controls who did not.
Cases were matched to controls 1:5 on type of surgery.
The team considered 16 risk factors and 14 outcomes.
The doctors found that 5 risk factors were predictors of GI complications.
|Patients with GI complications experience more negative outcomes.|
|Journal of the American College of Surgeons|
Patients were more likely to be older than age 70, to be on dialysis, to have left ventricular hypertrophy, and to be on anticoagulants. Their procedure was also more likely to be urgent.
Using regression analysis the team found that patients had a 3-fold increase in the risk of GI complications if they were over 70 years (OR 1.06), on dialysis (OR 1.87) , and their procedure was urgent (OR 1.91).
The team also determined that patients with GI complications had a greater risk of mortality, required more additional procedures, and suffered arrhythmia that required treatment. They were also more likely to have neurologic, pulmonary, renal, and sternal wound complications.
These patients also had greater length of hospitalization, intensive care unit length of hospitalization, ventilator time, and postoperative creatine phosphokinase levels.
Dr Matthew Recht's team concluded, "In patients undergoing CABG surgery, urgency of the procedure, age greater than 70 years, and dialysis all significantly increased the risk of a GI complication".
"Patients with GI complications also experienced more negative outcomes".