BACKGROUND:Gastrointestinal perforation after coronary artery bypass graft (CABG) surgery is often difficult to diagnose and is associated with high morbidity and mortality rates. The aim of this study was to determine risk factors for this complication in the studied population to further improve prophylaxis and diagnosis in the region of study. METHODS:Of 8,975 consecutive patients undergoing CABG during 10 years (1995-2005), 15 (0.16%) developed gastrointestinal perforation requiring laparatomy. Data from patients who experienced gastrointestinal perforation were analyzed using univariate tests in a controlled retrospective design. RESULTS:Prolonged bypass time and preoperative heparin administration were found to be significant (P<0.05) risk factors. CONCLUSION:Low splanchnic blood flow and vasoconstriction might be underlying factors associated with both predictors. With current findings, however, clear inference about preoperative and postoperative predictors and their relation is not possible. With more information, the next step would be to build a prediction model in recognition of gastrointestinal perforation after CABG on the basis of the predisposing factors.

译文

背景:冠状动脉搭桥术(CABG)术后的胃肠道穿孔通常难以诊断,并与高发病率和高死亡率相关。这项研究的目的是确定所研究人群中这种并发症的危险因素,以进一步改善研究区域的预防和诊断。
方法:在10年间(1995-2005年)的8,975例连续接受CABG的患者中,有15例(0.16%)发生了需要开腹手术的胃肠道穿孔。在受控的回顾性设计中,使用单变量检验对经历了胃肠道穿孔的患者的数据进行了分析。
结果:延长旁路时间和术前给予肝素是重要的危险因素(P <0.05)。
结论:低内脏血流量和血管收缩可能是与这两个预测因素相关的潜在因素。然而,根据目前的发现,不可能明确推断出术前和术后的预测因素及其关系。有了更多的信息,下一步将是基于诱发因素建立CABG后识别胃肠道穿孔的预测模型。

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