Zakeri, R.;
Freemantle, N.;
Barnett, V.;
Lipkin, G. W.;
Bonser, R. S.;
Graham, T. R.;
Rooney, S. J.;
... Pagano, D.; + view all
(2005)
Relation between mild renal dysfunction and outcomes after coronary artery bypass grafting.
Circulation
, 112
(9 Supp)
I270-I275.
Preview |
PDF
7535.pdf Download (342kB) |
Abstract
Background: Risk stratification algorithms for coronary artery bypass grafting (CABG) do not include a weighting for preoperative mild renal impairment defined as a serum creatinine 130 to 199 micromol/L (1.47 to 2.25 mg/dL), which may impact mortality and morbidity after CABG. Methods and results: We reviewed prospectively collected data between 1997 and 2004 on 4403 consecutive patients undergoing first-time isolated CABG with a preoperative serum creatinine <200 micromol/L (2.26 mg/dL)] in a single institution. The in-hospital mortality was 2.5% (112 of 4403), the need for new dialysis/hemofiltration was 1.3% (57 of 4403), and the stroke rate was 2.5% (108 of 4403). There were 458 patients with a serum creatinine 130 to 199 micromol/L or 1.47 to 2.25 mg/dL (mild renal dysfunction group) and 3945 patients with a serum creatinine <130 micromol/L (<1.47 mg/dL). Operative mortality was higher in the mild renal dysfunction group (2.1% versus 6.1%; P<0.001) and increased with increasing preoperative serum creatinine level. New dialysis/hemofiltration (0.8%versus 5.2%; P<0.001) and postoperative stroke (2.2% versus 5.0%; P<0.01) were also more common in the patients with mild renal impairment. Multivariate analysis adjusting for known risk factors confirmed preoperative mild renal impairment (creatinine 130 to 199 micromol/L or 1.47 to 2.25 mg/dL; odd ratio, 1.91; 95% CI, 1.18 to 3.03; P=0.007) or glomerular filtration rate estimates <60 mL/min per 1.73 m2, derived using the Cockroft-Gault formula, (odds ratio, 1.98; 95% CI, 1.16 to 3.48; P=0.015) as independent predictors of in-hospital mortality. Preoperative mild renal dysfunction adversely affected the 3-year survival probability after CABG (93% versus 81%; P<0.001). Conclusions: Mild renal dysfunction is an important predictor of outcome in terms of in-hospital mortality, morbidity, and midterm survival in patients undergoing CABG.
Type: | Article |
---|---|
Title: | Relation between mild renal dysfunction and outcomes after coronary artery bypass grafting |
Identifier: | PMID: 16159830 |
Open access status: | An open access version is available from UCL Discovery |
Publisher version: | http://www.circ.ahajournals.org/cgi/content/abstra... |
Language: | English |
Keywords: | Coronary artery bypass grafting, coronary disease, renal dysfunction |
UCL classification: | UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci > Department of Surgical Biotechnology |
URI: | https://discovery.ucl.ac.uk/id/eprint/7535 |
Archive Staff Only
View Item |