Introduction
Gastrointestinal (GI) complications are rare but often fatal consequences of cardiac surgery, especially after cardiopulmonary bypass (CPB) operations. The therapy can be conservative or - in critical cases - surgical; however, an early and safe diagnosis may prevent the development of life-threatening GI complications. The aim of our study was to characterize the risk factors and perioperative predictors for GI complications treated by laparotomy after CPB operations.
Methods
In a retrospective analysis of 12 years of CPB operations, 13,553 consecutive patients were involved in the study. Laparotomy was performed after CPB in 277 (2.01%) cases, the mean follow-up time was 63.9 months.
Results
Logistic regression analysis of the preoperative data demonstrated RR = 1.585 (OR: 1.340 to 1.876, P < 0.001) for heart failure according to the NYHA classification. The postoperative data analysis showed an RR = 12.257 (OR: 9.604 to 15.643, P < 0.001) for the need of an IABP implantation and an RR = 13.455 (OR: 10.516 to 17.215, P < 0.001) of low output syndrome in the GI complications group. In contrast, GI disease in the patient history seemed not to be a significant risk factor. Preoperative renal failure had an RR = 2.181 (OR: 1.686 to 2.821, P < 0.001) until postoperative renal failure had an RR = 29.145 (OR: 21.322 to 39.839, P < 0.001).
Conclusions
A failing heart may play a significant role in critical GI complications after CPB, whereas history of GI disease does not seem to determine its incidence.