Impact of renal dysfunction on outcomes of coronary artery bypass surgery : Results from the society of thoracic surgeons national adult cardiac database

Although patients with end-stage renal disease are known to be at high risk for mortality after coronary artery bypass graft (CABG) surgery, the impact of lesser degrees of renal impairment has not been well studied. The purpose of this study was to compare outcomes in patients undergoing CABG with...

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Bibliographic Details
Published in:Circulation (New York, N.Y.) N.Y.), 2006-02, Vol.113 (8), p.1063-1070
Main Authors: COOPER, William A, O'BRIEN, Sean M, THOURANI, Vinod H, GUYTON, Robert A, BRIDGES, Charles R, SZCZECH, Lynda A, PETERSEN, Rebecca, PETERSON, Eric D
Format: Article
Language:English
Subjects:
Biological and medical sciences
Blood and lymphatic vessels
Cardiology. Vascular system
Coronary Artery Bypass - adverse effects
Coronary Artery Bypass - mortality
Coronary Artery Disease - complications
Coronary Artery Disease - mortality
Coronary Artery Disease - surgery
Coronary Disease - complications
Coronary Disease - surgery
Coronary heart disease
Databases, Factual
Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous
Glomerular Filtration Rate
Heart
Humans
Kidney Diseases - complications
Kidney Diseases - diagnosis
Kidney Diseases - mortality
Medical sciences
Morbidity
Mortality
Postoperative Complications - etiology
Predictive Value of Tests
Prognosis
Regression Analysis
Risk Assessment
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Treatment Outcome
Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels
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Summary:Although patients with end-stage renal disease are known to be at high risk for mortality after coronary artery bypass graft (CABG) surgery, the impact of lesser degrees of renal impairment has not been well studied. The purpose of this study was to compare outcomes in patients undergoing CABG with a range from normal renal function to dependence on dialysis. We reviewed 483,914 patients receiving isolated CABG from July 2000 to December 2003, using the Society of Thoracic Surgeons National Adult Cardiac Database. Glomerular filtration rate (GFR) was estimated for patients with the use of the Modification of Diet in Renal Disease study formula. Multivariable logistic regression was used to determine the association of GFR with operative mortality and morbidities (stroke, reoperation, deep sternal infection, ventilation >48 hours, postoperative stay >2 weeks) after adjustment for 27 other known clinical risk factors. Preoperative renal dysfunction (RD) was common among CABG patients, with 51% having mild RD (GFR 60 to 90 mL/min per 1.73 m2, excludes dialysis), 24% moderate RD (GFR 30 to 59 mL/min per 1.73 m2, excludes dialysis), 2% severe RD (GFR
ISSN:0009-7322
1524-4539
DOI:10.1161/CIRCULATIONAHA.105.580084