Does off-pump CABG reduce gastrointestinal complications?
BACKGROUND
The aim of this study was to compare gastrointestinal complications and associated risk factors among patients undergoing cardiac surgery using off- and on-pump revascularization techniques.


METHODS
A total of 1146 adult patients who underwent coronary artery surgery during a 6-year period were evaluated retrospectively. Group 1 consisted of 546 patients operated using off-pump techniques and group 2 consisted of 600 cases operated with cardiopulmonary bypass. Patients were compared and evaluated for gastrointestinal complications and possible associated risk factors using univariate and multivariate logistic regression analysis.


RESULTS
Overall mortality was 1.6% in group 1 and 2.2% in group 2 (p = 0.523). Mortality due to gastrointestinal complications was 38.5% and 35.7% respectively in group 1 and group 2. The mean EuroSCORE value was 5.1 +/- 2.8 in group 1 and 3.8 +/- 2.4 in group 2 (p < 0.001). The most common gastrointestinal complication in the off-pump group was gastrointestinal bleeding. The leading complication in group 2 was intestinal ischemia.


CONCLUSIONS
The incidence rates of gastrointestinal complications were similar in the on- and off-pump coronary artery bypass groups, the type of gastrointestinal complications, however, was different. Mortality rate due to these complications was also similar and remained high, regardless of the type of surgery. Cardiopulmonary bypass did not emerge as a risk factor for gastrointestinal complications, but prolonged cardiopulmonary bypass (longer than 98 minutes) resulted in a high incidence of such complications. Old age and advanced arteriosclerosis emerged as risk factors in both groups resulting in gastrointestinal complications suggesting the ischemic nature of the injury.
Sanisoglu
Ilhan
I
Department of Cardiovascular Surgery, Kadir Has University Medical Faculty, Florence Nightingale Hospital, Istanbul, Turkey.
Guden
Mustafa
M
Bayramoglu
Zehra
Z
Sagbas
Ertan
E
Dibekoglu
Cengiz
C
Sanisoglu
S Yavuz
SY
Akpinar
Belhhan
B
D000368:Aged; D002315:Cardiopulmonary Bypass; D002423:Cause of Death; D001026:Coronary Artery Bypass / Q000379:methods*; D003327:Coronary Disease / Q000401:mortality / Q000601:surgery*; D005069:Evaluation Studies as Topic; D005260:Female; D005767:Gastrointestinal Diseases / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis