{"title":"心脏手术中延长体外循环对胃肠道并发症的影响：一项回顾性队列研究。","authors":"Xiaofang Yang, Ning Lu, Luxi Yang, Boxia Li, Wenjun Zhou, Yuanmin Li, Bing Song, Jinqiu Yuan, Wenbo Meng","doi":"10.1186/s13741-025-00524-w","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Gastrointestinal complications (GICs) following cardiac surgery with cardiopulmonary bypass (CPB) significantly impact postoperative recovery and clinical outcomes.</p><p><strong>Methods: </strong>This single-center, retrospective cohort study evaluated the incidence, risk factors, and outcomes of GICs in patients undergoing cardiac surgery with CPB between January 2018 and December 2023. Patients were stratified by CPB duration (≥ 120 min vs. < 120 min). Propensity Score Matching (PSM) in a 1:2 ratio was used to control for baseline confounders. The primary outcome was the occurrence of GICs within 30 days post-surgery.</p><p><strong>Results: </strong>Among 1444 patients, 686 had prolonged CPB duration, with an overall GICs incidence of 8.59% (124/1444). After PSM, the prolonged CPB group exhibited a significantly higher incidence of GICs compared to the normal CPB group (8.09% vs. 4.31%, p = 0.041). Multivariate logistic regression identified prolonged CPB duration (≥ 120 min; OR, 1.86; 95% CI, 1.06-3.26, p = 0.029), hypertension (OR 1.86; 95% CI, 1.01-3.44; p = 0.049), left ventricular ejection fraction (LVEF; OR, 0.92; 95% CI, 0.88-0.96; p < 0.001), and aortic surgery (OR, 2.72; 95% CI, 1.20-6.19; p = 0.017) as independent risk factors for GICs. Additionally, prolonged ventilator time and higher in-hospital costs were more prevalent in the prolonged CPB group.</p><p><strong>Conclusions: </strong>Prolonged CPB (≥ 120 min), hypertension, LVEF, and aortic surgery are significant risk factors for GICs following cardiac surgery with CPB. Early identification of high-risk patients may facilitate timely intervention, reduce complications, and improve postoperative recovery outcomes.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov: NCT06697405.</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":"14 1","pages":"42"},"PeriodicalIF":2.0000,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11998269/pdf/","citationCount":"0","resultStr":"{\"title\":\"Impact of prolonged cardiopulmonary bypass on gastrointestinal complications in cardiac surgery: a retrospective cohort study.\",\"authors\":\"Xiaofang Yang, Ning Lu, Luxi Yang, Boxia Li, Wenjun Zhou, Yuanmin Li, Bing Song, Jinqiu Yuan, Wenbo Meng\",\"doi\":\"10.1186/s13741-025-00524-w\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Gastrointestinal complications (GICs) following cardiac surgery with cardiopulmonary bypass (CPB) significantly impact postoperative recovery and clinical outcomes.</p><p><strong>Methods: </strong>This single-center, retrospective cohort study evaluated the incidence, risk factors, and outcomes of GICs in patients undergoing cardiac surgery with CPB between January 2018 and December 2023. Patients were stratified by CPB duration (≥ 120 min vs. < 120 min). Propensity Score Matching (PSM) in a 1:2 ratio was used to control for baseline confounders. The primary outcome was the occurrence of GICs within 30 days post-surgery.</p><p><strong>Results: </strong>Among 1444 patients, 686 had prolonged CPB duration, with an overall GICs incidence of 8.59% (124/1444). After PSM, the prolonged CPB group exhibited a significantly higher incidence of GICs compared to the normal CPB group (8.09% vs. 4.31%, p = 0.041). Multivariate logistic regression identified prolonged CPB duration (≥ 120 min; OR, 1.86; 95% CI, 1.06-3.26, p = 0.029), hypertension (OR 1.86; 95% CI, 1.01-3.44; p = 0.049), left ventricular ejection fraction (LVEF; OR, 0.92; 95% CI, 0.88-0.96; p < 0.001), and aortic surgery (OR, 2.72; 95% CI, 1.20-6.19; p = 0.017) as independent risk factors for GICs. Additionally, prolonged ventilator time and higher in-hospital costs were more prevalent in the prolonged CPB group.</p><p><strong>Conclusions: </strong>Prolonged CPB (≥ 120 min), hypertension, LVEF, and aortic surgery are significant risk factors for GICs following cardiac surgery with CPB. Early identification of high-risk patients may facilitate timely intervention, reduce complications, and improve postoperative recovery outcomes.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov: NCT06697405.</p>\",\"PeriodicalId\":19764,\"journal\":{\"name\":\"Perioperative Medicine\",\"volume\":\"14 1\",\"pages\":\"42\"},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2025-04-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11998269/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Perioperative Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s13741-025-00524-w\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ANESTHESIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Perioperative Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s13741-025-00524-w","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景：心脏手术合并体外循环（CPB）术后胃肠道并发症（gic）显著影响术后恢复和临床结果。方法：这项单中心、回顾性队列研究评估了2018年1月至2023年12月期间接受CPB心脏手术的患者发生GICs的发生率、危险因素和结局。根据CPB持续时间对患者进行分层(≥120 min vs.结果：1444例患者中，686例CPB持续时间延长，总体GICs发生率为8.59%（124/1444）。PSM后，延长CPB组的GICs发生率明显高于正常CPB组（8.09%比4.31%,p = 0.041）。多因素logistic回归发现CPB持续时间延长(≥120 min；或者,1.86;95% CI, 1.06-3.26, p = 0.029)，高血压(OR 1.86；95% ci, 1.01-3.44；p = 0.049)，左室射血分数(LVEF；或者,0.92;95% ci, 0.88-0.96；结论：CPB时间延长（≥120分钟）、高血压、LVEF和主动脉手术是CPB心脏手术后发生GICs的重要危险因素。早期识别高危患者有助于及时干预，减少并发症，提高术后恢复效果。试验注册：ClinicalTrials.gov: NCT06697405。
Impact of prolonged cardiopulmonary bypass on gastrointestinal complications in cardiac surgery: a retrospective cohort study.
Background: Gastrointestinal complications (GICs) following cardiac surgery with cardiopulmonary bypass (CPB) significantly impact postoperative recovery and clinical outcomes.
Methods: This single-center, retrospective cohort study evaluated the incidence, risk factors, and outcomes of GICs in patients undergoing cardiac surgery with CPB between January 2018 and December 2023. Patients were stratified by CPB duration (≥ 120 min vs. < 120 min). Propensity Score Matching (PSM) in a 1:2 ratio was used to control for baseline confounders. The primary outcome was the occurrence of GICs within 30 days post-surgery.
Results: Among 1444 patients, 686 had prolonged CPB duration, with an overall GICs incidence of 8.59% (124/1444). After PSM, the prolonged CPB group exhibited a significantly higher incidence of GICs compared to the normal CPB group (8.09% vs. 4.31%, p = 0.041). Multivariate logistic regression identified prolonged CPB duration (≥ 120 min; OR, 1.86; 95% CI, 1.06-3.26, p = 0.029), hypertension (OR 1.86; 95% CI, 1.01-3.44; p = 0.049), left ventricular ejection fraction (LVEF; OR, 0.92; 95% CI, 0.88-0.96; p < 0.001), and aortic surgery (OR, 2.72; 95% CI, 1.20-6.19; p = 0.017) as independent risk factors for GICs. Additionally, prolonged ventilator time and higher in-hospital costs were more prevalent in the prolonged CPB group.
Conclusions: Prolonged CPB (≥ 120 min), hypertension, LVEF, and aortic surgery are significant risk factors for GICs following cardiac surgery with CPB. Early identification of high-risk patients may facilitate timely intervention, reduce complications, and improve postoperative recovery outcomes.
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