Hepatic and gastrointestinal complications after adult cardiac surgery

Mohammed  Metwally; Noha Helal; Khaled Hassan; Abdelmoniem Ahmed; Mohammed  Elgazzar

doi:10.35810/ects.v5i1.242

Mohammed Metwally Department of Hepatology, Infectious disease and Gastroenterology, Faculty of Medicine, Banha University, Banha, Egypt
Noha Helal Department of Cardiothoracic Surgery, Faculty of Medicine, Banha University, Banha, Egypt
Khaled Hassan Department of Critical Care Medicine, Faculty of Medicine, Banha University, Banha, Egypt
Abdelmoniem Ahmed Department of Internal Medicine, Faculty of Medicine, Banha University, Banha, Egypt
Mohammed Elgazzar Department of Cardiothoracic Surgery, Faculty of Medicine, Banha University, Banha, Egypt

DOI: https://doi.org/10.35810/ects.v5i1.242

Keywords: Hepatic complications, Gastrointestinal complications, Cardiac surgery

Abstract

Background: Gastrointestinal tract (GIT) complications are associated with increased morbidity and mortality after cardiac surgery. Therefore, The goal of this research was to estimate the frequency of GIT and hepatic complications after cardiac surgery and to determine the risk factors for these complications. Additionally, we studied the effect of these complications on the outcomes of surgery.

Methods: This longitudinal study included 139 consecutive patients who underwent elective cardiac surgery. Patients were grouped according to the GIT and hepatic complications into two groups. Postoperative outcomes were compared between the two groups.

Results The mean age was 59.43 years, and 106 patients were males (76%). The GIT and hepatic complications rate was 15.8% (n= 22). Hepatic dysfunction occurred in 8.6% of cases, GIT bleeding in 2.9%, paralytic ileus in 2.2%, fulminant hepatic failure in 2.2%, and GIT bleeding combined with paralytic ileus in 0.7%. The overall mortality was 7.2 % (n= 10). The mortality rate in patients who developed GIT and hepatic complications was 45.5% (n= 10 out of 22 patients). There was statistically significantly higher mortality (10 (45.5%) vs. 0; P= 0.001), cardiac arrest (10 (45.5%) vs. 3 (2.6%); P= 0.001), and reoperation rate (5 (22.7%) vs. 6 (5.1%); P= 0.005) among patients with GIT or hepatic complications.

Conclusion: Patients with hepatic and GIT complications could have higher mortality, morbidity, and longer hospital stay than the non-complicated group.