PMID- 15708149
OWN - NLM
STAT- MEDLINE
DCOM- 20050623
LR  - 20131121
IS  - 0149-7944 (Print)
IS  - 0149-7944 (Linking)
VI  - 62
IP  - 1
DP  - 2005 Jan-Feb
TI  - Non-dialysis-dependent renal dysfunction and cardiac surgery-an assessment of 
      perioperative risk factors.
PG  - 64-70
AB  - OBJECTIVE: In most reports, dialysis-dependent patients are known to be at 
      increased risk for perioperative morbidity and mortality after cardiac surgical 
      procedures.(1-7) However, the preoperative factors important for risk 
      stratification of patients who have renal insufficiency but are not dialysis 
      dependent are unclear. We set forth to ascertain preoperative risk factors 
      important for predicting 2 endpoints: (1) dialysis at discharge and (2) hospital 
      death. DESIGN: A retrospective analysis. SETTING: A tertiary referral center. 
      PATIENTS: From a database of patients undergoing cardiopulmonary bypass over a 
      6-year period, 150 patients were chosen for study based on their preoperative 
      creatinine being greater than 1.5 mg/dl. INTERVENTIONS: Routine monitoring and 
      care of patients after their cardiac surgical procedures. MEASUREMENTS AND MAIN 
      RESULTS: Many preoperative, perioperative, and postoperative variables were 
      measured. Multivariable regression was used for data analysis. There were 21 
      (14%) hospital deaths and 7 (5%) patients who were not on preoperative dialysis 
      who required dialysis at discharge. Preoperative risk factors for hospital death 
      were the patients' New York Heart Association (NYHA) class (p = 0.004) and 
      emergency status (p = 0.005). Preoperative risk factors for dialysis at discharge 
      were female gender (p = 0.02), emergency status of procedure (p = 0.01), and 
      preoperative creatinine (p = 0.03). CONCLUSIONS: These data allow for a more 
      accurate assessment of risk stratification in this group of patients with renal 
      insufficiency but who are not dependent on dialysis. Given the data presented 
      here and other studies that report good outcomes for patients with renal disease 
      after cardiac surgical procedures,(8-10) earlier operative intervention for 
      coronary disease in this subset of patients might be warranted.
FAU - Kowdley, Gopal C
AU  - Kowdley GC
AD  - Department of Surgery, University of Chicago Hospitals, Chicago, Illinois, USA. 
      gopal.kowdley@us.army.mil
FAU - Maithal, Shishir
AU  - Maithal S
FAU - Ahmed, Shafqat
AU  - Ahmed S
FAU - Naftel, David
AU  - Naftel D
FAU - Karp, Robert
AU  - Karp R
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Curr Surg
JT  - Current surgery
JID - 7802123
RN  - AYI8EX34EU (Creatinine)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Cardiopulmonary Bypass/*adverse effects
MH  - Creatinine/analysis
MH  - Emergencies
MH  - Female
MH  - Hospital Mortality
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Postoperative Complications
MH  - Predictive Value of Tests
MH  - Renal Dialysis/statistics & numerical data
MH  - Renal Insufficiency/*complications
MH  - Reoperation
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Risk Factors
MH  - Sex Factors
EDAT- 2005/02/15 09:00
MHDA- 2005/06/24 09:00
CRDT- 2005/02/15 09:00
PHST- 2005/02/15 09:00 [pubmed]
PHST- 2005/06/24 09:00 [medline]
PHST- 2005/02/15 09:00 [entrez]
AID - S0149-7944(04)00097-2 [pii]
AID - 10.1016/j.cursur.2004.06.007 [doi]
PST - ppublish
SO  - Curr Surg. 2005 Jan-Feb;62(1):64-70. doi: 10.1016/j.cursur.2004.06.007.