K. Gopal. Bellam1, S. Sabe2, J. Heath3, D. Harris4, A. Oh5, N. Chalasani6, N. Feldman7, M. Broadwin8, C. Stone5, A. Ehsan9, F. Sellke10 1Warren Alpert Medical School of Brown University, Providence, Rhode Island 2Brown University/Rhode Island Hospital, Boston, Massachusetts 3Warren Alpert Medical School, Providence, Rhode Island 4Beth Israel Deaconess Medical Center, Boston, Massachusetts 5Brown University, Providence, Rhode Island 6USF Medical School, Tampa, Florida 7Brown, Providence, Rhode Island 8Browm, Providence, Rhode Island 9Brown University/Rhode Island Hospital, Newton, Massachusetts 10Brown University/Rhode Island Hospital, Providence, Rhode Island
Warren Alpert Medical School of Brown University Providence, Rhode Island, United States
Disclosure(s):
Krishna Gopal Bellam, n/a: No financial relationships to disclose
Purpose: Given the poorly understood relationship between inflammatory bowel disease (IBD), a known risk factor for cardiac disease and dysfunction, and cardiac surgery outcomes, we aimed to elucidate clinical implications of IBD-related cardiac dysfunction among cardiac surgery patients (IBD vs. non-IBD) by determining characteristics and outcomes following coronary artery bypass grafting. Methods: We utilized the Nationwide Inpatient Sample (NIS) data from 2012-2021 for CABG patients ≥ 18 years old. Patients were subsequently sorted into two groups based on presence or absence of IBD diagnosis. The primary outcome was in-hospital mortality, and secondary outcomes included cost and length of stay, and post-operative complications including infection, acute kidney injury, stroke, cardiogenic shock, vascular complications, arrythmia, bleeding, and others. Patient characteristics including age, sex, race, and preexisting comorbidities were collected, and multivariable modeling was used to adjusting for confounding variables were utilized. Results: A total of 353,024 patients met the inclusion criteria, with 1,072 patients having a diagnosis of IBD. Following CABG, patients with IBD had a non-significant trend towards increased in-hospital mortality (OR = 1.10, [0.76 – 1.59]). Additionally, patients with IBD had significantly increased odds of infection (OR = 1.51, [1.12 – 2.04]), acute myocardial infarction (OR = 1.37, [1.22 – 1.55]), acute mesenteric ischemia (OR = 4.48, [2.00 – 10.04]), acute coronary dissection (OR = 1.92, [1.08 – 3.39]), acute pericardial effusion (OR = 1.47, [1.01 – 2.13]), and acute gastrointestinal bleeding (OR = 2.75, [1.67 – 4.51]). IBD patients had decreased odds of TIA/stroke (OR = 0.41, [0.27 – 0.61]) and cardiogenic shock (OR = 0.73, [0.55 – 0.98]). IBD patients also had a significantly increased length of stay (mean 10.56 days vs. 9.80 days, p=0.001) compared to non-IBD patients following CABG. Conclusion: IBD patients undergoing CABG are at increased risk of several postoperative complications including infection, acute myocardial infarction, acute mesenteric ischemia, coronary artery dissection, pericardial effusion, gastrointestinal bleeding, and increased length of stay. Interestingly in this cohort, IBD patients were less likely to develop TIA/stroke or cardiogenic shock and had decreased hospitalization costs. Further research into IBD-related cardiac dysfunction in the setting of CABG is warranted to better understand these differences and their clinical implications on peri-operative monitoring and management of these patients.
Identify the source of the funding for this research project: N/A
