title: Gastrointestinal complications after cardiac surgery: 10-year experience of a single Australian centre.
abstract: BACKGROUND
  Gastrointestinal (GI) complications after cardiac surgery are uncommon, but are associated with high morbidity and mortality as well as significant hospital resource utilization.
  
  
  METHODS
  We analysed a prospectively collected database containing all adult cardiac surgery procedures performed from July 2001 to March 2011 at Monash Medical Centre and Jessie McPherson Private Hospital. Patients with post-operative GI complications were compared to patients without GI complications who were operated in the same period.
  
  
  RESULTS
  The incidence of GI complications was 1.1% (61 out of 5382 patients) with an overall 30-day mortality of 33% (versus 3% in the non-GI complication group). The most common complications were GI bleeding, gastroenteritis and bowel ischaemia. Patients who had GI complications were significantly older, had higher incidence of renal impairment, chronic lung disease and anticoagulation therapy and were more likely to be in cardiogenic shock. Emergency procedures, combined coronary artery bypass grafting and valve surgery and aortic dissection cases were more common in the GI complication group. The GI complication group also had higher incidence of return to theatre, renal failure, stroke, septicaemia and multi-organ failure.
  
  
  CONCLUSIONS
  GI complications after cardiac surgery remain an uncommon but dreadful complication associated with high mortality. Our findings should prompt a high degree of clinical vigilance in order to make an early diagnosis especially in high risk patients. Further studies aiming to identify independent predictors for GI complications after cardiac surgery are warranted.
authors.affiliation: Department of Cardiothoracic Surgery, Monash Medical Centre, Clayton, Victoria, Australia. ff_viana@hotmail.com
authors.forename: Fabiano F
authors.initials: FF
authors.lastname: Viana
authors.forename: Yi
authors.initials: Y
authors.lastname: Chen
authors.forename: Aubrey A
authors.initials: AA
authors.lastname: Almeida
authors.forename: Heather D
authors.initials: HD
authors.lastname: Baxter
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Cochrane
authors.forename: Julian A
authors.initials: JA
authors.lastname: Smith
mesh_terms: D000328:Adult; D000368:Aged; D006348:Cardiac Surgical Procedures; D016022:Case-Control Studies; D041881:Cholecystitis, Acute / Q000453:epidemiology / Q000209:etiology; D017091:Colitis, Ischemic / Q000453:epidemiology / Q000209:etiology; D016208:Databases, Factual; D005260:Female; D005759:Gastroenteritis / Q000453:epidemiology* / Q000209:etiology; D006471:Gastrointestinal Hemorrhage / Q000453:epidemiology* / Q000209:etiology; D048550:Hepatic Insufficiency / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D045823:Ileus / Q000453:epidemiology / Q000209:etiology; D015994:Incidence; D007416:Intestinal Perforation / Q000453:epidemiology / Q000209:etiology; D007422:Intestines / Q000098:blood supply*; D007511:Ischemia / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D019106:Postoperative Hemorrhage / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D014739:Victoria
keywords: cardiac surgery; gastrointestinal tract; post-operative complications; risk factors