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Postoperative complications following cardiac surgery with cardiopulmonary bypass


Cardiac surgery using cardiopulmonary bypass (CPB) is associated with a low mortality, and planned hospital stays of less than 7 days imply a low incidence of major morbidity. We challenge this notion, having observed considerable morbidity attributable to low grade organ dysfunction; the purpose of this study was to quantify postoperative morbidity.


A retrospective analysis of prospectively collected data on all adult cardiac surgery patients presenting at the Duke Heart Center 1993-1995. Thirty-one named complications were recorded and described as patients cardiac or non-cardiac (further ascribed to specific organs) and the hospital lengths of stay (Hlos) associated with each named complication was noted.


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The median and mode Hlos support the impression that the postoperative course is uncomplicated and routine. However, morbidity following cardiac surgery (37% of patients) is common and a significant proportion is non-cardiac. Of note, 25% of patients remain in hospital > 8 days, most with some manifestations of organ dysfunction. The caremap structure for postoperative cardiac patients at Duke aims to limit Hlos to < 7 days; to stay beyond 7 days at Duke is invariably associated with serious morbidity, so for a significant minority of patients, recovery from cardiac surgery is far from uneventful. The incentives for interventions designed to reduce such morbidity and its associated increased cost are huge [1].

Table 1 Demographics
Table 2 Mortality and morbidity


  1. Mythen MG, Webb AR: . Arch Surg. 1995, 130: 423-429.

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Atwell, D., Welsby, I., White, W. et al. Postoperative complications following cardiac surgery with cardiopulmonary bypass. Crit Care 1 (Suppl 1), P103 (1997).

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