Doenças Cardiovasculares e Diagnóstico

The Impact of Gastrointestinal Complications on Patients who Undergo Coronary Artery Bypass Grafting

Abstract

Anthony Lemaire, George Batsides, Aziz Ghaly, Al Solina, Victor Dombrovsky, Alan Spotnitz, and Leonard Y Lee

Objective: The incidence of gastrointestinal (GI) complications in patients undergoing coronary artery bypass grafting (CABG) is increasing as the population ages. The reported incidence ranges from 0.3% to 3.7%. Coronary Artery Bypass Grafting (CABG) is one of the most common operations performed. The outcome of patients who undergo abdominal operations for GI complications after CABG is not known. The purpose of the study is to determine the impact of abdominal surgery on patients who undergo CABG.

Methods: A retrospective review of nationwide data of all patients undergoing CABG from 2006 to 2010. A total of 160,513 patients who underwent CABG were reviewed.

Results: A total of 236 patients out of the 160,513 patients who underwent CABG developed GI complications that required abdominal surgery. The abdominal procedures included small and large bowel resections as well as colostomy formation. The indications for abdominal surgery varied and included ischemic bowel, and bowel obstruction. The patients who underwent concomitant abdominal surgery were more likely to develop renal Confidence Interval (CI) (8.5 to 14.2) (P<0.0001), respiratory CI (8.5 to 14.8) (P<0.0001), and infectious CI (16.3 to 28.6) (P<0.0001) complications. They were also more likely to have higher mortality CI (16.2 to 29.0), (P<0.0001). Patients who underwent abdominal operations had longer length of stay (LOS) 37.23 ± 32.8 days versus 8.2 ± 6.1 days (P<0.0001) and higher hospital charges, $389,586 ± 2 60,546 compared to $111,290 ± 82,462.2 (P<0.0001).

Conclusion: Although rare, the impact of abdominal surgery resulting from GI complications is significant. The patients who had abdominal surgery and underwent CABG were more likely to develop multiple complications. As a result, these patients had a higher rate of mortality, longer LOS, and higher hospital costs. Taken together, these results indicate that patients with GI complications should be identified promptly and aggressively treating these patients is of paramount importance.