PURPOSE: Intestinal ischaemia is an uncommon (<1%), but serious complication of cardiac surgery with a mortality rate exceeding 50%. Diagnosis of this potentially lethal condition can be difficult and a high index of suspicion is required for diagnosis. Early diagnosis and prompt surgical intervention can be lifesaving.
METHODS: In a retrospective case-note analysis from August 1999 to December 2010, we identified 31 cases of intestinal ischaemia in 9925 (0.31%) consecutive patients who underwent cardiac surgery.
RESULTS: Using logistic multivariate analysis, we have identified the following 4 predictors of mortality in patients who developed acute intestinal ischaemia after cardiac surgery: pre-operative logistic EuroSCORE, the need for pre-operative anti-coagulation, the amount of intra-operative blood transfusion, and the base excess at the point of diagnosis of acute intestinal ischaemia.
CONCLUSIONS: The diagnosis and prompt treatment of acute intestinal ischaemia after cardiac surgery requires a high index of suspicion. Despite early diagnosis and surgical intervention, mortality rates remain high.
CLINICAL IMPLICATIONS: These predictors identified in our study may help in prognostication of patients who suffer acute intestinal ischaemia after cardiac surgery.
DISCLOSURE: The following authors have nothing to disclose: Philip, Yi Kit Pang, Yoong Kong Sin, Yeong Phang Lim, Chong Hee Lim, Teing Ee Tan, See Lim Lim, Jang Wen Su, Victor, Tar Toong Chao, Yeow Leng Chua
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