Mild renal failure is associated with adverse outcome after cardiac valve surgery

被引:66
作者
Anderson, RJ
O'Brien, M
MaWhinney, S
VillaNueva, CB
Moritz, TE
Sethi, GK
Henderson, WG
Hammermeister, KE
Grover, FL
Shroyer, L
机构
[1] Univ Colorado, Hlth Sci Ctr, Dept Vet Affairs Med Ctr, Denver, CO 80262 USA
[2] Univ Colorado, Hlth Sci Ctr, Dept Med, Denver, CO 80262 USA
[3] Univ Colorado, Hlth Sci Ctr, Dept Surg, Denver, CO 80262 USA
关键词
renal failure; surgical outcomes;
D O I
10.1016/S0272-6386(00)70050-3
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
The present study was performed to ascertain whether the presence of mild renal failure (defined as a serum creatinine concentration of 1.5 to 3.0 mg/dL) is an independent risk factor. for adverse outcome after cardiac valve surgery. An extensive set of preoperative and postoperative data was collected in 834 prospectively evaluated patients undergoing cardiac valve surgery at 14 Veterans Affairs Medical Centers. Univariate and multivariable analyses were performed to determine whether an independent association of mild renal dysfunction with adverse outcomes was present. Patients with mild renal failure had significantly greater do-day mortality rates (P = 0.001; 16% versus 6%) and frequency of postoperative bleeding (P = 0.023; 16% versus 8%), respiratory complications (P = 0.02, 29% versus 16%), and cardiac complications (P = 0.002; 18% versus 7%) than patients with normal renal function (serum creatinine <1.5 mg/dL) when controlling for multiple other variables. The presence of a serum creatinine concentration of 1.5 to 3.0 mg/dL is significantly and independently associated with adverse outcomes after cardiac valve surgery. (C) 2000 by the National Kidney Foundation, Inc.
引用
收藏
页码:1127 / 1134
页数:8
相关论文
共 45 条
  • [1] Renal failure predisposes patients to adverse outcome after coronary artery bypass surgery
    Anderson, RJ
    O'Brien, M
    MaWhinney, S
    VillaNueva, CB
    Moritz, TE
    Sethi, GK
    Henderson, WG
    Hammermeister, KE
    Grover, FL
    Shroyer, AL
    [J]. KIDNEY INTERNATIONAL, 1999, 55 (03) : 1057 - 1062
  • [2] Ash A, 1994, Risk Adjustment for Measuring Health Care Outcomes, P313
  • [3] Determinants of early and late mortality in patients with end-stage renal disease undergoing cardiac surgery
    Ashraf, SS
    Shaukat, N
    Kamaly, ID
    Durrani, A
    Doran, B
    Grotte, GJ
    Keenan, DJ
    [J]. SCANDINAVIAN JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 1995, 29 (04): : 187 - 193
  • [4] BLUM U, 1994, PRESSE MED, V23, P28
  • [5] IN-HOSPITAL AND LONG-TERM MORTALITY IN MALE VETERANS FOLLOWING NONCARDIAC SURGERY
    BROWNER, WS
    LI, J
    MANGANO, DT
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1992, 268 (02): : 228 - 232
  • [6] CHRISTAKIS GT, 1985, CIRCULATION, V72, P120
  • [7] CHRISTAKIS GT, 1988, CIRCULATION, V78, P25
  • [8] THE SOCIETY-OF-THORACIC-SURGEONS NATIONAL DATABASE STATUS-REPORT
    CLARK, RE
    [J]. ANNALS OF THORACIC SURGERY, 1994, 57 (01) : 20 - 26
  • [9] Aortic valve replacement for aortic stenosis with severe left ventricular dysfunction - Prognostic indicators
    Connolly, HM
    Oh, JK
    Orszulak, TA
    Osborn, SL
    Roger, VL
    Hodge, DO
    Bailey, KR
    Seward, JB
    Tajik, AJ
    [J]. CIRCULATION, 1997, 95 (10) : 2395 - 2400
  • [10] CRITERIA BY WHICH TO EVALUATE RISK-ADJUSTED OUTCOMES PROGRAMS IN CARDIAC-SURGERY
    DALEY, J
    [J]. ANNALS OF THORACIC SURGERY, 1994, 58 (06) : 1827 - 1835