Risk factors and prevention of upper gastrointestinal hemorrhage after a coronary artery bypass grafting operation

Surg Today. 2010 Oct;40(10):931-5. doi: 10.1007/s00595-009-4160-0. Epub 2010 Sep 25.

Abstract

Purpose: Upper gastrointestinal (GI) hemorrhage is a serious complication of coronary artery bypass grafting (CABG). The aim of this study was to retrospectively investigate the risk factors and prevention of upper GI bleeding after CABG.

Methods: This study followed 6316 coronary patients who underwent CABG from 1998 to 2005. The perioperative parameters were recorded. Data from patients who experienced major gastrointestinal complications were analyzed retrospectively by univariate and multivariate analyses.

Results: The rate of upper GI bleeding was 0.3%. The overall mortality for patients complicated by upper GI bleeding was 47.6%. The risk factors for upper GI bleeding were age (odds ratio [OR] = 3.18, 95% confidence interval [CI] = 1.73-5.87, P < 0.01), extracorporeal circulation time (OR = 1.30, 95% CI = 1.11-1.52, P < 0.01) and the prophylactic use of omeprazole (OR = 0.19, 95% CI = 0.04-0.89, P < 0.05). The long-term mortality was significantly different between the upper GI bleeding group and the controls (P < 0.01).

Conclusion: Advanced age and extracorporeal circulation time were risk factors for upper GI bleeding after CABG, and the prophylactic use of omeprazole decreased the rate of upper GI bleeding.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Confidence Intervals
  • Coronary Artery Bypass / adverse effects*
  • Coronary Artery Bypass / methods
  • Coronary Artery Disease / surgery*
  • Dose-Response Relationship, Drug
  • Enzyme Inhibitors / administration & dosage
  • Enzyme Inhibitors / therapeutic use
  • Extracorporeal Circulation / adverse effects
  • Female
  • Follow-Up Studies
  • Gastrointestinal Hemorrhage / epidemiology*
  • Gastrointestinal Hemorrhage / prevention & control
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Odds Ratio
  • Omeprazole / administration & dosage
  • Omeprazole / therapeutic use*
  • Postoperative Hemorrhage / epidemiology*
  • Postoperative Hemorrhage / prevention & control
  • Prospective Studies
  • Risk Factors
  • Survival Rate
  • Treatment Outcome

Substances

  • Enzyme Inhibitors
  • Omeprazole