Gastrointestinal complications following on-pump cardiac surgery—A propensity matched analysis

• DOI: 10.1371/journal.pone.0217874
• Publication Date: 2019-06-05T13:33:27Z
• Authors: Katharina Marsoner; Andreas Voetsch; Christoph Lierzer; Gottfried H. Sodeck; Sonja Fruhwald; Otto Dapunt; Hans Joerg Mischi...; Peter Kornprat
• Keywords: Interquartile range; Gastrointestinal bleeding

Background Gastrointestinal complications following on-pump cardiac surgery are orphan but serious risk factors for postoperative morbidity and mortality. We aimed to assess incidence, perioperative factors, treatment modalities outcomes. Material methods A university medical center audit comprised 4883 consecutive patients (median age 69 [interquartile range IQR 60–76] years, 33% female, median logistic EuroScore 5 [IQR 3–11]) undergoing all types of including on the thoracic aorta; repair congenital heart disease, implantation assist devices or transplantation were excluded. Coronary artery disease was leading indication (60%), under urgency emergency setting included in analysis. identified a total 142 with gastrointestinal complications. To identify intra- predictors complications, we applied 1:1 propensity score matching procedure based regression model. Results Overall, 30-day mortality entire cohort 5.4%; incidence 2.9% time complication 8 days (IQR 4–12). Acute pancreatitis (n = 41), paralytic ileus 14) acute cholecystitis 18) pathologies. Mesenteric ischemia bleeding accounted 16 vs. 18 cases, respectively. While 72 (51%) could be managed conservatively, 27 required endoscopic/radiological (19%) surgical intervention (43/142 patients, 30%); overall 12.1% (p<0.001). Propensity prolonged skin-to-skin times (p 0.026; Odds Ratio OR 1.003, 95% Confidence Interval CI 1.000–1.007) extended periods 0.010; 1.006, 95%CI 1.001–1.011) as significant factors. Comment Prolonged important regardless preoperative