Universität zu Köln

Djordjevic, I., Eghbalzadeh, K., Heinen, S., Schlachtenberger, G., Gerfer, S., Sabashnikov, A., Merkle, J., Weber, C., Kuhn, E., Zeriouh, M., Rahmanian, P., Mader, N., Liakopoulos, O. -J. and Wahlers, T. (2020). Risk Factors Associated with In-Hospital Mortality for Patients with Acute Abdomen After Cardiac Surgery. World J.Surg., 44 (1). S. 277 - 285. NEW YORK: SPRINGER. ISSN 1432-2323

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Abstract

Objectives Management of acute abdomen (AA) differs due to the heterogeneity of underlying pathophysiology. Complications of AA and its overall outcome after cardiac surgery are known to be associated with poor results. The aim of this retrospective analysis was to evaluate risk factors for AA in patients undergoing cardiac surgery. Methods Between December 2011 and December 2014, a total of 131 patients with AA after cardiac surgery were identified and retrospectively analyzed using our institutional database. Statistical analysis of risk factors concerning in-hospital mortality of mentioned patient cohort was performed using IBM SPSS Statistics. Results Overall in-hospital mortality was 54.2% (71/131). Analyzing in-hospital non-survivors (NS) versus in-hospital survivors (S) peripheral artery disease (28.2% vs. 11.7%; p = 0.03), the need for assist device therapy (33.8% vs. 16.7%; p = 0.03) and the requirement of hemodialysis (67.6% vs. 23.3%; p < 0.01) were significantly higher in NS. Furthermore, lactic acid values at onset of symptoms were shown to be significantly higher in NS (5.7 +/- 5.7 mmol/L vs. 2.8 +/- 2.9 mmol/L; p < 0.01). Assured diagnosis of mesenterial ischemia was strongly associated with worse outcome (odds ratio 10.800, 95% confidence interval 2.003-58.224; p = 0.006). Conclusion In conclusion, in critically ill patients after performed cardiac surgery peripheral vascular disease, need for supportive hemodynamic assist device systems and occurrence of renal failure are risk factors associated with worsen outcome. Additionally, rise of lactic acid could potentially be associated with onset of intestinal malperfusion and should be taken into account in therapeutic decisions preventing fatal mesenterial ischemia.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Djordjevic, I. UNSPECIFIED UNSPECIFIED UNSPECIFIED Eghbalzadeh, K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Heinen, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schlachtenberger, G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Gerfer, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Sabashnikov, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Merkle, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Weber, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuhn, E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Zeriouh, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Rahmanian, P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Mader, N. UNSPECIFIED UNSPECIFIED UNSPECIFIED Liakopoulos, O. -J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Wahlers, T. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-131046
DOI:	10.1007/s00268-019-05227-0
Journal or Publication Title:	World J.Surg.
Volume:	44
Number:	1
Page Range:	S. 277 - 285
Date:	2020
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1432-2323
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ACUTE MESENTERIC ISCHEMIA; GASTROINTESTINAL COMPLICATIONS; CARDIOPULMONARY BYPASS; INTESTINAL ISCHEMIA; LACTATE LEVELS; VASOPRESSIN; PATHOPHYSIOLOGY; MORBIDITY; DIAGNOSIS; THERAPY Multiple languages Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/13104