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Incidence and outcome of gastrointestinal complications after cardiopulmonary bypass

^a Department of Cardiothoracic Surgery, University of Cologne, Germany
^b Department of Visceral and Vascular Surgery, University of Cologne, Germany
^c Department of Cardiology, University of Cologne, Germany

*Corresponding author: Klinik für Herz- und Thoraxchirurgie, im Klinikum der Universität zu Köln, Joseph-Stelzmann-Str. 9, 50924 Köln, Germany. Tel.: +49 221 478 4128; fax: +49 221 478 4186.

E-mail address: hans.geissler{at}uk-koeln.de (H.J. Geissler).

Gastrointestinal complications (GI-complications) after CPB are rare, but are associated with high mortality and hospital cost. This retrospective analysis investigates the incidence, patient profile and post-operative course of GI-complications after CPB. The charts of 8869 adult patients, operated on CPB between 1995 and 2002, were reviewed. Patients with post-OP GI-complications were compared to a control group of 1057 consecutive patients operated on CPB between 05/2000 and 04/2001. The incidence of GI-complications was 0.79% with an overall mortality of 21.5% (vs. 3% in controls, P<0.05). Most frequent were upper GI-tract-bleeding (58%), followed by pancreatitis (11%) and cholecystitis (10%). GI-complications were diagnosed 9.2±5.9 days after surgery, with 58.5% after a primarily uneventful post-op course. Compared to control, patients with GI-complications showed no difference in pre-operative comorbidity and EuroSCORE. However, surgery of the thoracic aorta, prolonged CPB time, and necessity for re-thoracotomy was significantly more frequent in patients with GI-complications (P<0.05). GI-complications after CPB remain a rare, but dreaded complication associated with high mortality. Early diagnosis may require a high degree of clinical vigilance as the majority of GI-complications occurred after a primarily uneventful post-op course. Age, co-morbidity, and EuroSCORE were not different between patients with GI-complications and control.

Key Words: Peri-operative complications; Gastrointestinal tract; Gastrointestinal hemorrhage; Risk factors