Outcomes of Emergency Gastrointestinal Surgery Done on Post-Cardiac Surgery Patients-Analysis From a Tertiary Care Center

التفاصيل البيبلوغرافية
العنوان: Outcomes of Emergency Gastrointestinal Surgery Done on Post-Cardiac Surgery Patients-Analysis From a Tertiary Care Center
المؤلفون: David Spielvogel, Steven L. Lansman, Syian Srikumar, Shekhar Gogna, Katherine French, Abbas Smiley, Rifat Latifi
المصدر: Surgical technology international. 39
سنة النشر: 2021
مصطلحات موضوعية: medicine.medical_specialty, Abdominal compartment syndrome, Exploratory laparotomy, medicine.medical_treatment, Tertiary Care Centers, Postoperative Complications, Valve replacement, Medicine, Humans, Hospital Mortality, Cardiac Surgical Procedures, Digestive System Surgical Procedures, Aged, Retrospective Studies, business.industry, General Medicine, Middle Aged, medicine.disease, Surgery, Cardiac surgery, Hospitalization, Cardiothoracic surgery, Acute abdomen, Ventricular assist device, General Surgery, Female, medicine.symptom, business, Abdominal surgery
الوصف: Introduction: Abdominal complications following cardiac surgery have high mortality rates. This study analyzes the outcomes of patients who have undergone emergency general surgery (EGS) procedures after cardiothoracic surgery (CTS) at the same hospitalization. Materials and Methods: This was a retrospective analysis of all patients who underwent emergent abdominal surgery after CTS surgery between 2010–2018. The CTS procedures included coronary artery bypass graft (CABG), valve replacement, cardiac transplant, aortic replacement, ventricular assist device, and pericardial procedures. The records were reviewed to obtain demographics, frequency distribution of EGS procedures, complications, outcomes, and the risk factors of mortality. Results: Of 4826 patients who had CTS, 57 (1.2%) underwent EGS procedures during the period of 2010–2018. This cohort of patients had 113 CTS and 85 EGS procedures during the same hospitalization. The mean age was 62 years, and 49% were elderly (40% were females). CABG with or without valve replacement was the most common surgery (28%). After surgical consultation for “acute abdomen” in the post-CTS phase, the three most common findings on exploratory laparotomy were bowel perforation (23%), massive free fluid leading to abdominal compartment syndrome (19%), and acute cholecystitis (16%). Respiratory failure (46%), acute kidney injury (32%), and multiple organ dysfunction (18%) were the most common hospital-acquired complications. Regarding dispositions, 47% were discharged to an acute rehabilitation center, 10% were discharged to a sub-acute rehabilitation center, and a similar proportion of patients went home (10%). On multivariable logistic regression analysis with backward elimination, age (OR=1.10, 95% CI: 1.02–1.18) and serum proteins (OR=0.99, 95% CI: 0.98-0.998) were independently associated with the odds of mortality after EGS in the immediate CTS phase. Conclusions: Respiratory failure is the most common complication of EGS immediately after CTS. The older the patient and the lower the serum proteins, the higher the odds of mortality in patients who undergo EGS after ETS.
تدمد: 1090-3941
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::b9c23d0f4c852c9626085eeade857616
https://pubmed.ncbi.nlm.nih.gov/34749424
رقم الانضمام: edsair.doi.dedup.....b9c23d0f4c852c9626085eeade857616
قاعدة البيانات: OpenAIRE