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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...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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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 |
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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 |
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