Cargando…

Short-Term Outcomes and Risk Factors of In-Hospital Mortality in Patients Suffering Acute Mesenteric Ischemia after Cardiac Surgery: Role of Opioids and Lactic Acid

Acute mesenteric ischemia (AMI) is associated with poor clinical results after cardiac surgery. The aim of this study was to analyse the influence of AMI on short-term outcomes and all relevant risk factors of in-hospital mortality after cardiac surgery. Moreover, we aimed to investigate the role of...

Descripción completa

Detalles Bibliográficos
Autores principales: Krasivskyi, Ihor, Djordjevic, Ilija, Tayeh, Mahmoud, Eghbalzadeh, Kaveh, Ivanov, Borko, Avgeridou, Soi, Gerfer, Stephen, Gaisendrees, Christopher, Suhr, Laura, Sabashnikov, Anton, Rustenbach, Christian Jörg, Mader, Navid, Doerr, Fabian, Wahlers, Thorsten
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9918177/
https://www.ncbi.nlm.nih.gov/pubmed/36769505
http://dx.doi.org/10.3390/jcm12030857
_version_ 1784886549688614912
author Krasivskyi, Ihor
Djordjevic, Ilija
Tayeh, Mahmoud
Eghbalzadeh, Kaveh
Ivanov, Borko
Avgeridou, Soi
Gerfer, Stephen
Gaisendrees, Christopher
Suhr, Laura
Sabashnikov, Anton
Rustenbach, Christian Jörg
Mader, Navid
Doerr, Fabian
Wahlers, Thorsten
author_facet Krasivskyi, Ihor
Djordjevic, Ilija
Tayeh, Mahmoud
Eghbalzadeh, Kaveh
Ivanov, Borko
Avgeridou, Soi
Gerfer, Stephen
Gaisendrees, Christopher
Suhr, Laura
Sabashnikov, Anton
Rustenbach, Christian Jörg
Mader, Navid
Doerr, Fabian
Wahlers, Thorsten
author_sort Krasivskyi, Ihor
collection PubMed
description Acute mesenteric ischemia (AMI) is associated with poor clinical results after cardiac surgery. The aim of this study was to analyse the influence of AMI on short-term outcomes and all relevant risk factors of in-hospital mortality after cardiac surgery. Moreover, we aimed to investigate the role of opioids and lactic acid in the detection and prevention of AMI. Between August 2011 and September 2015, 176 consecutive patients with gastrointestinal complications after undergoing open-heart surgery were identified and included in this study. All patients were divided into two groups: AMI group (n = 39) and non-AMI group (n = 137). In terms of comorbidities, the groups were fairly equal and showed no significant differences. Dialysis was significantly higher (p < 0.001) in patients that suffered from AMI. Moreover, gastro-intestinal symptoms such as muscular defense (p = 0.004) and the laparotomy rate (p < 0.001) were significantly higher in the AMI group. Likewise, in-hospital mortality (p < 0.001) was significantly higher in patients with detected AMI. Univariate (p < 0.001) and multivariate analysis (p = 0.025) of both groups revealed that lactic acid value >2 mmol/L and present treatment with opioids are independent combined predictors of mesenteric ischemia in patients after undergoing cardiac surgery. Moreover, multivariate analysis showed peripheral vascular disease (p = 0.004), dialysis (p = 0.010), and septic shock (p = 0.003) as relevant predictors of in-hospital mortality. Prolonged analgetic treatment with opioids and sudden increase of lactic acid levels are independent combined predictors of mesenteric ischemia in patients after undergoing cardiac surgery. Furthermore, peripheral vascular disease, dialysis, and septic shock are relevant predictors for in-hospital mortality.
format Online
Article
Text
id pubmed-9918177
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-99181772023-02-11 Short-Term Outcomes and Risk Factors of In-Hospital Mortality in Patients Suffering Acute Mesenteric Ischemia after Cardiac Surgery: Role of Opioids and Lactic Acid Krasivskyi, Ihor Djordjevic, Ilija Tayeh, Mahmoud Eghbalzadeh, Kaveh Ivanov, Borko Avgeridou, Soi Gerfer, Stephen Gaisendrees, Christopher Suhr, Laura Sabashnikov, Anton Rustenbach, Christian Jörg Mader, Navid Doerr, Fabian Wahlers, Thorsten J Clin Med Article Acute mesenteric ischemia (AMI) is associated with poor clinical results after cardiac surgery. The aim of this study was to analyse the influence of AMI on short-term outcomes and all relevant risk factors of in-hospital mortality after cardiac surgery. Moreover, we aimed to investigate the role of opioids and lactic acid in the detection and prevention of AMI. Between August 2011 and September 2015, 176 consecutive patients with gastrointestinal complications after undergoing open-heart surgery were identified and included in this study. All patients were divided into two groups: AMI group (n = 39) and non-AMI group (n = 137). In terms of comorbidities, the groups were fairly equal and showed no significant differences. Dialysis was significantly higher (p < 0.001) in patients that suffered from AMI. Moreover, gastro-intestinal symptoms such as muscular defense (p = 0.004) and the laparotomy rate (p < 0.001) were significantly higher in the AMI group. Likewise, in-hospital mortality (p < 0.001) was significantly higher in patients with detected AMI. Univariate (p < 0.001) and multivariate analysis (p = 0.025) of both groups revealed that lactic acid value >2 mmol/L and present treatment with opioids are independent combined predictors of mesenteric ischemia in patients after undergoing cardiac surgery. Moreover, multivariate analysis showed peripheral vascular disease (p = 0.004), dialysis (p = 0.010), and septic shock (p = 0.003) as relevant predictors of in-hospital mortality. Prolonged analgetic treatment with opioids and sudden increase of lactic acid levels are independent combined predictors of mesenteric ischemia in patients after undergoing cardiac surgery. Furthermore, peripheral vascular disease, dialysis, and septic shock are relevant predictors for in-hospital mortality. MDPI 2023-01-20 /pmc/articles/PMC9918177/ /pubmed/36769505 http://dx.doi.org/10.3390/jcm12030857 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Krasivskyi, Ihor
Djordjevic, Ilija
Tayeh, Mahmoud
Eghbalzadeh, Kaveh
Ivanov, Borko
Avgeridou, Soi
Gerfer, Stephen
Gaisendrees, Christopher
Suhr, Laura
Sabashnikov, Anton
Rustenbach, Christian Jörg
Mader, Navid
Doerr, Fabian
Wahlers, Thorsten
Short-Term Outcomes and Risk Factors of In-Hospital Mortality in Patients Suffering Acute Mesenteric Ischemia after Cardiac Surgery: Role of Opioids and Lactic Acid
title Short-Term Outcomes and Risk Factors of In-Hospital Mortality in Patients Suffering Acute Mesenteric Ischemia after Cardiac Surgery: Role of Opioids and Lactic Acid
title_full Short-Term Outcomes and Risk Factors of In-Hospital Mortality in Patients Suffering Acute Mesenteric Ischemia after Cardiac Surgery: Role of Opioids and Lactic Acid
title_fullStr Short-Term Outcomes and Risk Factors of In-Hospital Mortality in Patients Suffering Acute Mesenteric Ischemia after Cardiac Surgery: Role of Opioids and Lactic Acid
title_full_unstemmed Short-Term Outcomes and Risk Factors of In-Hospital Mortality in Patients Suffering Acute Mesenteric Ischemia after Cardiac Surgery: Role of Opioids and Lactic Acid
title_short Short-Term Outcomes and Risk Factors of In-Hospital Mortality in Patients Suffering Acute Mesenteric Ischemia after Cardiac Surgery: Role of Opioids and Lactic Acid
title_sort short-term outcomes and risk factors of in-hospital mortality in patients suffering acute mesenteric ischemia after cardiac surgery: role of opioids and lactic acid
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9918177/
https://www.ncbi.nlm.nih.gov/pubmed/36769505
http://dx.doi.org/10.3390/jcm12030857
work_keys_str_mv AT krasivskyiihor shorttermoutcomesandriskfactorsofinhospitalmortalityinpatientssufferingacutemesentericischemiaaftercardiacsurgeryroleofopioidsandlacticacid
AT djordjevicilija shorttermoutcomesandriskfactorsofinhospitalmortalityinpatientssufferingacutemesentericischemiaaftercardiacsurgeryroleofopioidsandlacticacid
AT tayehmahmoud shorttermoutcomesandriskfactorsofinhospitalmortalityinpatientssufferingacutemesentericischemiaaftercardiacsurgeryroleofopioidsandlacticacid
AT eghbalzadehkaveh shorttermoutcomesandriskfactorsofinhospitalmortalityinpatientssufferingacutemesentericischemiaaftercardiacsurgeryroleofopioidsandlacticacid
AT ivanovborko shorttermoutcomesandriskfactorsofinhospitalmortalityinpatientssufferingacutemesentericischemiaaftercardiacsurgeryroleofopioidsandlacticacid
AT avgeridousoi shorttermoutcomesandriskfactorsofinhospitalmortalityinpatientssufferingacutemesentericischemiaaftercardiacsurgeryroleofopioidsandlacticacid
AT gerferstephen shorttermoutcomesandriskfactorsofinhospitalmortalityinpatientssufferingacutemesentericischemiaaftercardiacsurgeryroleofopioidsandlacticacid
AT gaisendreeschristopher shorttermoutcomesandriskfactorsofinhospitalmortalityinpatientssufferingacutemesentericischemiaaftercardiacsurgeryroleofopioidsandlacticacid
AT suhrlaura shorttermoutcomesandriskfactorsofinhospitalmortalityinpatientssufferingacutemesentericischemiaaftercardiacsurgeryroleofopioidsandlacticacid
AT sabashnikovanton shorttermoutcomesandriskfactorsofinhospitalmortalityinpatientssufferingacutemesentericischemiaaftercardiacsurgeryroleofopioidsandlacticacid
AT rustenbachchristianjorg shorttermoutcomesandriskfactorsofinhospitalmortalityinpatientssufferingacutemesentericischemiaaftercardiacsurgeryroleofopioidsandlacticacid
AT madernavid shorttermoutcomesandriskfactorsofinhospitalmortalityinpatientssufferingacutemesentericischemiaaftercardiacsurgeryroleofopioidsandlacticacid
AT doerrfabian shorttermoutcomesandriskfactorsofinhospitalmortalityinpatientssufferingacutemesentericischemiaaftercardiacsurgeryroleofopioidsandlacticacid
AT wahlersthorsten shorttermoutcomesandriskfactorsofinhospitalmortalityinpatientssufferingacutemesentericischemiaaftercardiacsurgeryroleofopioidsandlacticacid