Gastrointestinal complications after coronary artery bypass grafting: a national study of morbidity and mortality predictors.
BACKGROUND
Previous single-institution studies have documented a 0.6% to 2.4% incidence of gastrointestinal (GI) complications after coronary artery bypass grafting (CABG), with an associated 14% to 63% mortality rate. To better determine the incidence and impact of GI complications after CABG, national outcomes for CABG were examined from 1998 to 2002.


METHODS
The Nationwide Inpatient Sample was queried for all patients undergoing CABG (ICD9 procedure codes 36.10 to 36.16). Two cohorts were compared: CABGs with and without GI complications. Both demographic and outcomes variables were compared by either t-test or chi-square analysis. Logistic regression analyses indicated potential predictors of CABG inpatient mortality and GI complications after CABG.


RESULTS
The incidence of GI complications among 2.7 million CABGs identified was 4.1%. Total hospital length of stay (19.3 versus 8.8 days) and inpatient mortality (12.0% versus 2.5%, both p < 0.0001) were increased in CABG patients having GI complications. Factors associated with increased risk of GI complications included: age greater than 65 years (odds ratio [OR], 2.1); hemodialysis (OR, 3.4); intraaortic balloon pump (OR, 1.6); concomitant valve procedure (OR, 1.5); and procedure urgency (OR, 1.22). Use of an internal mammary graft was protective (OR, 0.5), but GI complications increased inpatient mortality risk (OR, 2.6).


CONCLUSIONS
This national population-based study indicates that GI complications after CABG occur at a higher rate than previously described, leading to increased hospital length of stay and mortality.
Division of General Surgery, Department of Surgery, Stanford University Medical Center, Stanford, CA 94305-5655, USA.
Filiberto
F
Rodriguez
Tom C
TC
Nguyen
Joseph A
JA
Galanko
John
J
Morton
D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D019992:Databases as Topic; D005260:Female; D005767:Gastrointestinal Diseases / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D009026:Mortality; D012189:Retrospective Studies; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology