THE INCIDENCE OF GASTROINTESTINAL SYMPTOMS IN CARDIAC-SURGERY PATIENTS THROUGH 6 WEEKS AFTER-DISCHARGE

OBJECTIVE: To determine the incidence and the effect of intraoperative and discharge variables on gastrointestinal (GI) symptoms after cardi ac surgery during hospitalization and 2 and 6 weeks after discharge. D ESIGN: Prospective and descriptive. SETTING: Two university-affiliated medical centers. PATIENTS: One hundred twenty-two adult patients unde rgoing cardiac surgery. OUTCOME MEASURES: Frequency of GI symptoms and level of distress caused by GI symptoms during hospitalization and 2 and 6 weeks after hospital discharge. INSTRUMENTS: GI symptoms were me asured by The Gastrointestinal Symptom Frequency and Symptom Distress Scale. Depression was measured by The Center for Epidemiologic Studies Depression Scale. INTERVENTION: Demographic and physiologic variables were collected by chart review. Patients completed the Gastrointestin al Symptom Frequency and Symptom Distress Scale and The Center for Epi demiologic Studies Depression Scale in the hospital. Telephone intervi ews were used to collect 2- and 6-week data. RESULTS: Fifty-seven perc ent of patients after surgery reported poor appetite, 37% lack of tast e, and 34% nausea during hospitalization. The frequency of all GI symp toms decreased with time; 19% of subjects reported poor appetite, 19% lack of taste, and 10% nausea at 6 weeks after discharge. Although poo r appetite occurred with the greatest frequency, patients reported the greatest distress with lack of taste. When analyzed with a logistic r egression model, use of antihypertensive agents was associated with la ck of taste; use of diuretic and antiarrhythmic agents was associated with nausea; and level of depression was associated with all three GI symptoms. Length of cardiopulmonary bypass time, mean arterial blood p ressure during surgery, mixed venous oxygen saturation during surgery, and subject age did not significantly affect the frequency of GI symp toms at any data collection point. CONCLUSIONS: The incidence of GI sy mptoms after cardiac surgery is significant, but their etiology has ye t to be determined.