Document Detail


Long-term survival after cardiac surgery is predicted by estimated glomerular filtration rate.
MedLine Citation:
PMID:  18573389     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Estimated glomerular filtration rate (eGFR) before coronary artery bypass graft (CABG) surgery is a key risk factor of in-hospital mortality. However, in patients with normal renal function before CABG, acute kidney injury develops after the procedure, making postoperative renal function assessment necessary for evaluation. Postoperative eGFR and its association with long-term survival have not been well studied. METHODS: We studied 13,593 consecutive CABG patients in northern New England from 2001 to 2006. Patients with preoperative dialysis were excluded. Data were linked to the Social Security Association Death Master File to assess long-term survival. Kaplan-Meier and log-rank techniques were used. Patients were stratified by established categories of postoperative eGFR (90 or greater, 60 to 89, 30 to 59, 15 to 29, and less than 15 mL x min(-1) x 1.73 m(-2)). RESULTS: Median follow-up was 2.8 years (mean, 2.7; range, 0 to 5.5). Patients with moderate to severe acute kidney injury (less than 60) after CABG had significantly worse survival than patients with little or no acute kidney injury (90 or greater). CONCLUSIONS: Patients having moderate to severe acute kidney injury after CABG surgery had worse 5-year survival compared with patients who had normal or near-normal renal function.
Authors:
Jeremiah R Brown; Richard P Cochran; Todd A MacKenzie; Anthony P Furnary; Karyn S Kunzelman; Cathy S Ross; Craig W Langner; David C Charlesworth; Bruce J Leavitt; Lawrence J Dacey; Robert E Helm; John H Braxton; Robert A Clough; Robert F Dunton; Gerald T O'Connor;
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  86     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2008 Jul 
Date Detail:
Created Date:  2008-06-24     Completed Date:  2008-07-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  4-11     Citation Subset:  AIM; IM    
Affiliation:
Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH 03756, USA. jeremiah.r.brown@dartmouth.edu
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MeSH Terms
Descriptor/Qualifier:
Age Distribution
Aged
Aged, 80 and over
Cohort Studies
Coronary Artery Bypass / adverse effects,  mortality*
Coronary Disease / diagnosis,  mortality*,  surgery
Creatinine / blood
Female
Follow-Up Studies
Glomerular Filtration Rate / physiology*
Hospital Mortality / trends*
Humans
Incidence
Kaplan-Meiers Estimate
Kidney Failure, Acute / diagnosis*,  etiology,  mortality
Male
Middle Aged
Postoperative Complications / diagnosis,  mortality
Predictive Value of Tests
Proportional Hazards Models
Retrospective Studies
Risk Assessment
Sex Distribution
Survival Analysis
Time Factors
Chemical
Reg. No./Substance:
60-27-5/Creatinine
Comments/Corrections
Comment In:
Ann Thorac Surg. 2008 Jul;86(1):1-3   [PMID:  18573388 ]
Ann Thorac Surg. 2008 Jul;86(1):11-2   [PMID:  18573390 ]

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


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