2005 Abstracts: GI Complications of Coronary Artery Bypass Grafting
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GI Complications of Coronary Artery Bypass Grafting
Filiberto Rodriguez, Stanford School of Medicine, Department of Surgery, Stanford, CA; John Morton, Stanford School of Medicine, Stanford, CA
Background: Coronary artery bypass grafting (CABG) is one of the most commonly performed procedures in the US. While CABG cardio-vascular adverse events are well described little is known about gastro-intestinal (GI) complications. To determine the prevalence and impact of GI complications for CABGs, national outcomes for CABGs were examined from 1998-2002.
Methods: The National Inpatient Sample, a 20% sample of all non-federal hospital discharges, was queried for all patients who had a CABG by ICD9 procedure codes 36.10-36.16. Hospital transfers and pediatric patients were excluded. Two cohorts were created for comparison: CABGs with no GI complications and CABGs with GI complications. Both demographic and outcome variables were compared by either T-test or Chi-Square analysis with a P value of < 0.05 as significant. Confounding variables were controlled for with linear and logistic regression models for LOS and mortality respectively. Results: The prevalence of GI complications among all CABGs was 4%. No clinically significant demographic differences existed between the two groups who were also matched on general severity of illness, admission acuity, and associated procedures. Significant differences in LOS and mortality between CABGs with and without GI complications existed respectively: LOS (Days, 19+/-40 vs. 8+/-15, p<0.0001), and in-patient mortality (%, 12.4 vs. 2.4, p<0.0001). In addition, logistic regression analysis indicated potential predictors for mortality in all CABGs. IMA use was associated with a protective effect on mortality [Odds Ratio (OR), 0.5] while the following variables carried an increased risk of mortality: age>65 (OR, 3.7), concomitant valve procedure (OR, 1.9), and GI complications (2.9). Conclusions: This population-based study indicates that GI complications associated with CABG occur at a higher rate than previously described. In addition, CABG GI complications lead to increased LOS and mortality. Potentially, predictors of CABG GI complications may be identified in order to reduce these adverse events.
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