Eastern Cardiothoracic Surgical Society

The Impact of Gastrointestional Complications on Patients Who Undergo Coronary Artery Bypass Grafting
Anthony Lemaire, George Batsides, Aziz Ghaly, Alan Spotnitz, Leonard Y. Lee, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ

OBJECTIVE: The incidence of gastrointestinal (GI) complications in patients undergoing coronary artery bypass grafting (CABG) is increasing as the population ages. The incidence ranges from 0.3% to 3.7%. 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 inpatient sample of all patients undergoing CABG from 2006 to 2010. A total of 160,513 patients were reviewed.

RESULTS: A total of 236 patients of the 160,513 patients who underwent CABG developed GI complications that required surgery. The procedures included bowel resections and colostomy formation. The indications for 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 had higher mortality 26.69% to 1.65% CI (16.2 to 29.0), (P<0.0001), longer length of stay (LOS) 37.23 32.8 days versus 8.2 6.1 days (P<0.0001) and higher hospital charges, ,586 260,546 compared to ,290 82,462.2 (P<0.0001).

CONCLUSIONS: Although rare, the impact of abdominal surgery is significant. These patients were more likely to develop complications and had higher rates of mortality, and longer LOS. These results indicate that patients with GI complications should be aggressively treated.