BUN AS A RISK FACTOR FOR MORTALITY AFTER CORONARY-ARTERY BYPASS-GRAFTING

被引:19
作者
HARTZ, AJ [1 ]
KUHN, EM [1 ]
KAYSER, KL [1 ]
JOHNSON, WD [1 ]
机构
[1] MILWAUKEE HEART SURG ASSOCIATES,MILWAUKEE,WI
关键词
D O I
10.1016/0003-4975(95)00358-R
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background. Although information on blood urea nitrogen (BUN) is universally available for patients who undergo coronary artery bypass grafting, BUN has not often been considered as a risk factor for mortality. This study assessed BUN as a risk factor for CABG patients. Methods. Four data sets were evaluated that differed with respect to the types of patients and available patient information. In each of these data sets logistic regression analysis was used to examine the relationship between BUN and mortality after adjusting for other risk factors. Results. Blood urea nitrogen level was strongly associated with mortality in each of the data sets. After adjustment for the available risk factors other than creatinine level, patients with BUN levels greater than 30 mg/dL had a relative odds of mortality ranging between 1.86 and 2.49 (p < 0.0001 in three of the data sets). Even after adjustment for creatinine level as well as the other variables, BUN was statistically significant at the p less than 0.01 level for three of the data sets. Conclusions. The results suggest that BUN provides additional information on cardiac function that supplements the information provided by other risk factors.
引用
收藏
页码:398 / 404
页数:7
相关论文
共 23 条
[1]  
Kennedy, Kaiser, Fisher, Et al., Multivariate discriminant analysis of the clinical and angiographic predictors of operative mortality from the Collaborative Study in Coronary Artery Surgery (CASS), J Thorac Cardiovasc Surg, 80, pp. 876-887, (1980)
[2]  
Pennsylvania Health Care Cost Containment Council, Coronary artery bypass graft surgery: technical report, 3, (1994)
[3]  
Higgins, Fawzy, Loop, Et al., Stratification of morbidity and mortality outcome by preoperative risk factors in coronary artery bypass patients: a clinical severity score, JAMA, 267, pp. 2344-2348, (1992)
[4]  
Myers, Davis, Foster, Maynard, Kaiser, Surgical survival in the Coronary Artery Surgery Study (CASS) registry, Ann Thorac Surg, 40, pp. 245-260, (1985)
[5]  
Kennedy, Kaiser, Fisher, Et al., Clinical and angiographic predictors of operative mortality from the Collaborative Study in Coronary Artery Surgery (CASS), Circulation, 63, pp. 793-802, (1981)
[6]  
O'Connor, Plume, Olmstead, Et al., Multivariate prediction of in-hospital mortality associated with coronary artery bypass graft surgery, Circulation, 85, pp. 2110-2118, (1992)
[7]  
Parsonnet, Dean, Bernstein, A method of uniform stratification of risk for evaluating the results of surgery in acquired adult heart disease, Circulation, 79, pp. 3-12, (1989)
[8]  
Hartz, Kuhn, Kayser, Pryor, Green, Rimm, Assessing providers of coronary revascularization: a method for peer review organization, Am J Public Health, 82, pp. 1631-1640, (1992)
[9]  
Hartz, Kuhn, Green, Rimm, The use of routinely collected data to assess quality of care for coronary artery bypass surgery and angioplasty, Int J Technol Assess Health Care, 8, pp. 524-538, (1992)
[10]  
O'Connor, Plume, Olmstead, Et al., A regional prospective study of in-hospital mortality associated with coronary artery bypass grafting, JAMA, 266, pp. 803-809, (1991)