| On-pump versus off-pump coronary artery bypass grafting: impact on postoperative renal failure requiring renal replacement therapy. | |
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MedLine Citation:
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PMID: 15063246 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Despite refinements in perioperative patient management postoperative renal failure requiring hemofiltration or dialysis is still a common complication after coronary artery bypass grafting associated with impaired patient outcome. METHODS: Prospective data on 9,631 patients receiving myocardial revascularization with (coronary artery bypass grafting [n = 8,870]) or without cardiopulmonary bypass (off-pump coronary artery bypass grafting [n = 761]) between April 1996 and August 2001 were evaluated by univariate and multivariate logistic regression analysis. RESULTS: Overall prevalence of postoperative continuous renal replacement therapy was 4.1% (coronary artery bypass grafting, 4.3%; off-pump coronary artery bypass grafting, 1.8%; p = 0.001). Thirty of 40 selected preoperative and intraoperative patient and treatment related variables had a high association with the requirement for postoperative renal replacement therapy; fifteen of these variables were independent predictors in the whole study population. Off-pump coronary artery bypass surgery was identified as having a significantly lower predictive value for postoperative continuous renal placement therapy. In the subgroup of patients undergoing off-pump coronary artery bypass grafting surgery, a second multivariate logistic regression model revealed preoperative cardiogenic shock, urgent operation, intraoperative low cardiac output, and high transfusion requirement as independent predictors for postoperative renal replacement therapy. CONCLUSIONS: Patients with preoperative nondialysis dependent renal insufficiency are at a high risk for further decline in renal function requiring postoperative continuous renal replacement therapy. Off-pump coronary artery bypass surgery is associated with a lower prevalence of postoperative renal replacement therapy after coronary artery bypass grafting. |
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Authors:
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Jan Bucerius; Jan F Gummert; Thomas Walther; Dierk V Schmitt; Nicolas Doll; Volkmar Falk; Friedrich W Mohr |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: The Annals of thoracic surgery Volume: 77 ISSN: 0003-4975 ISO Abbreviation: Ann. Thorac. Surg. Publication Date: 2004 Apr |
Date Detail:
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Created Date: 2004-04-05 Completed Date: 2004-05-06 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 15030100R Medline TA: Ann Thorac Surg Country: United States |
Other Details:
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Languages: eng Pagination: 1250-6 Citation Subset: AIM; IM |
Affiliation:
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Department of Cardiac Surgery, Heart Center, University of Leipzig, Leipzig, Germany. bucerj@medizin.uni-leipzig.de |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Cardiopulmonary Bypass / adverse effects* Coronary Artery Bypass / adverse effects* Female Hemofiltration* Humans Kidney Failure / etiology*, physiopathology, therapy Logistic Models Male Middle Aged Postoperative Complications / therapy |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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