Recht et al identified risk factors associated with gastrointestinal (GI) complications following coronary artery bypass graft (CABG) surgery. This can help identify patients who may require closer monitoring and more aggressive therapy to reduce these complications. The authors are from Good Samaritan Hospital (Trihealth) in Cincinnati, Ohio.
Gastrointestinal complications:
(1) bleeding requiring transfusion or other therapy
(2) perforated peptic ulcer
(3) cholecystitis
(4) hepatitis
(5) pancreatitis
(6) bowel obstruction
(7) prolonged ileus
(8) intestinal ischemia
Parameters:
(1) age of the patient
(2) dialysis
(3) left ventricular status
(4) anticoagulant therapy
(5) timeliness of surgery
|
Parameter
|
Finding
|
Points
|
|
age of the patient
|
<= 70 years of age
|
0
|
|
|
> 70 years of age
|
1
|
|
dialysis required
|
no
|
0
|
|
|
yes
|
1
|
|
left ventricular status
|
not hypertrophied
|
0
|
|
|
hypertrophied
|
1
|
|
anticoagulant therapy
|
none
|
0
|
|
|
present
|
1
|
|
timeliness of surgery
|
elective
|
0
|
|
|
urgent
|
1
|
number of risk factors =
= SUM(points for all 5 parameters)
Interpretation:
• minimum number of risk factors: 0
• maximum number of risk factors: 5
• The more risk factors, the greater the risk of gastrointestinal complications.
Patients who developed GI complications were at greater risk for:
(1) mortality
(2) additional surgical procedures
(3) significant cardiac arrhythmias
(4) sternal wound complications
(5) longer length of hospitalization
(6) longer ICU stay
(7) longer time on the ventilator and pulmonary complications
(8) neurologic and renal complications
