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Title: Multiple risk assessment of cardiovascular surgery in chronic renal failure patients. Author: Witczak B, Hartmann A, Svennevig JL. Journal: Ann Thorac Surg; 2005 Apr; 79(4):1297-302. PubMed ID: 15797066. Abstract: BACKGROUND: Chronic renal failure is a major risk factor in cardiovascular surgery. We evaluated results of cardiovascular surgery in chronic renal failure patients (s-creatinine > 200 micromol/L or established dialysis) at our center from 1990 to 2000. METHODS: One hundred and six chronic renal failure patients underwent cardiovascular surgery (56 coronary artery bypass operations, 25 valve replacements with or without coronary bypass, and 25 other major cardiovascular operations [8 thoracic aorta, 10 abdominal aorta, 7 other]). Matched controls were selected (n = 106) based on age, sex, year, and type of operation and occurrence of diabetes. RESULTS: There were 88 men and 18 women and mean age was 64 +/- 10 years (standard deviation). Demographics did not differ between chronic renal failure and control patients, except for hypertension (more prevalent in chronic renal failure group, p < 0.05). Intraoperative hemorrhage, perfusion and ischemia time, and reoperation did not differ between groups. Chronic renal failure patients received more transfusions of red blood cells, plasma, and platelets (p < 0.02). Ventilation support (27.6 +/- 59.3 hours), intensive care unit stay (7.7 +/- 8.3 days), and hospital stay (12.3 +/- 10.5 days) were longer (p < 0.02). Early mortality was 16% versus 6.6% (p = 0.04) and 5-year mortality was 79% versus 39% (p < 0.05) for chronic renal failure and control patients, respectively. Independent preoperative risk factors of mortality for chronic renal patients were age greater than 70 years (relative risk = 2.32, p = 0.001), chronic obstructive pulmonary disease (relative risk = 2.59, p = 0.001), diabetes (relative risk = 1.80, p = 0.037), and dialysis (relative risk = 2.03, p = 0.005). CONCLUSIONS: Chronic renal failure patients suffered more postoperative complications and had substantially increased short-term and long-term mortality rates. Independent preoperative mortality risk factors for chronic renal failure patients were age, chronic obstructive pulmonary disease, diabetes, and chronic dialysis.[Abstract] [Full Text] [Related] [New Search]