Impact of Concomitant Cardiac Procedure on Coronary Artery Surgery in Hemodialysis-dependent Patients

Overview

Journal Jpn J Thorac Cardiovasc Surg

Specialties Cardiology & Vascular Diseases
General Surgery
Pulmonary Medicine

Date 2006 Apr 29

PMID 16642919

Citations 1

Authors

Koji Kawahito

Hideo Adachi

Sei-ichiro Murata

Atsushi Yamaguchi

Takashi Ino

Affiliations

Soon will be listed here.

Abstract

Objective: Coronary artery bypass grafting (CABG) in hemodialysis-dependent patients is associated with high mortality and morbidity rates. This retrospective study was undertaken to identify the risk factors for in-hospital mortality for hemodialysis-dependent patients.

Methods: Subjects included 87 consecutive hemodialysis-dependent patients (81 men and 6 women), aged 47-82 years (mean age, 65 years), who underwent CABG. Operative procedures included CABG alone (n=77) and CABG with valve replacement, repair, or the Dor procedure (n=10). Thirty-one perioperative risk factors were subjected to univariate and multivariate analyses to identify the risk factors for hospital death.

Results: The overall in-hospital mortality rate, including operative death, was 14.9% (13/87). Univariate analysis showed the following 7 risk factors to be statistically significant predictors of hospital death: age > or = 70 years, a concomitant cardiac procedure, left ventricular ejection fraction <30%, left ventricular end-systolic volume index >70 ml/m2, a left main lesion, emergency/urgent surgery, and anemia (hemoglobin <10 mg/dl) (p<0.05 for each predictor). Multivariate logistic regression analysis confirmed that a concomitant cardiac procedure (chi-squared = 17.080, p=0.013) and age > or = 70 years (chi-squared = 9.112, p=0.019) are statistically significant independent risk factors for hospital death.

Conclusion: A concomitant cardiac procedure and age > or = 70 years were identified as significant independent risk factors for hospital mortality after CABG for hemodialysis-dependent patients. These preoperative risk factors may help in predicting operative risks and improving clinical outcomes in hemodialysis-dependent patients undergoing CABG.

Citing Articles

Risk factors for open heart surgery in hemodialysis patients.

Yamamura M, Mitsuno M, Tanaka H, Kobayashi Y, Ryomoto M, Nishi H Gen Thorac Cardiovasc Surg. 2009; 57(5):235-8.

PMID: 19440818 DOI: 10.1007/s11748-008-0372-2.

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