Document Detail


Creatinine clearance and risk of early mortality in patients undergoing coronary artery bypass grafting.
MedLine Citation:
PMID:  16153923     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: We sought to evaluate renal function assessed on the basis of calculated creatinine clearance as a predictor of early mortality and postoperative complications in patients undergoing coronary artery bypass grafting and to assess whether calculated creatinine clearance is superior to serum creatinine concentration in predicting early death postoperatively. METHODS: Six thousand seven hundred eleven consecutive patients without dialysis-dependent renal insufficiency undergoing a first isolated coronary artery bypass grafting were included. Preoperative serum creatinine concentrations and creatinine clearance calculated by using the Cockroft-Gault formula were related to mortality within 30 days postoperatively. RESULTS: There were 136 early deaths. After adjustment for age and other confounders in multivariate analyses, moderate (calculated creatinine clearance 30-60 mL/min) and severe (calculated creatinine clearance < 30 mL/min) renal insufficiency predicted early mortality (odds ratio of 2.4 [95% confidence interval, 1.2-4.8] and odds ratio of 4.8 [95% confidence interval], 1.6-13.9, respectively) compared with normal (calculated creatinine clearance > or = 90 mL/min) renal function. The area under the receiver operating characteristic curve for calculated creatinine clearance and serum creatinine concentration was 0.71 and 0.62, respectively, yielding a difference of 0.08 (P = .0004). No increased risk of mediastinitis or bleeding was observed in patients with renal insufficiency. CONCLUSION: Moderate and severe renal insufficiency independently increase the risk of early death after coronary artery bypass grafting. Our results indicate that calculated creatinine clearance is a better predictor of early mortality postoperatively than serum creatinine concentration.
Authors:
Martin J Holzmann; Staffan Ahnve; Niklas Hammar; Lena Jörgensen; Kristina Klerdal; Kenneth Pehrsson; Torbjörn Ivert
Related Documents :
15213633 - Suprarenal fixation of endograft in abdominal aortic aneurysm treatment: focus on renal...
1865503 - Measures of renal function in patients with cisplatin-related chronic renal disease.
3555353 - Acute graft-vs-host disease. development following autologous and syngeneic bone marrow...
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  130     ISSN:  0022-5223     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  2005 Sep 
Date Detail:
Created Date:  2005-09-12     Completed Date:  2005-11-03     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  746-52     Citation Subset:  AIM; IM    
Affiliation:
Department of Thoracic Surgery, Karolinska University Hospital, Stockholm, Sweden. martin.holzmann@karolinska.se
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aged
Coronary Artery Bypass / mortality*
Creatinine / blood,  metabolism*
Female
Humans
Kidney / physiopathology*
Kidney Failure / physiopathology
Male
Middle Aged
Postoperative Complications
ROC Curve
Risk Factors
Chemical
Reg. No./Substance:
60-27-5/Creatinine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Prognostic significance of dysadherin expression in patients with non-small cell lung cancer.
Next Document:  Intraoperative detection of lymph node micrometastasis with flow cytometry in non-small cell lung ca...