Preoperative renal function as a predictor of survival after coronary artery bypass grafting: Comparison with a matched general population

van Straten, Albert H. M., Hamad, Mohamed A. Soliman, van Zundert, Andre A. J., Martens, Elisabeth J., Schonberger, Jacques P. A. M. and de Wolf, Andre M. (2009) Preoperative renal function as a predictor of survival after coronary artery bypass grafting: Comparison with a matched general population. Journal of Thoracic and Cardiovascular Surgery, 138 4: 971-976. doi:10.1016/j.jtcvs.2009.05.026


Author van Straten, Albert H. M.
Hamad, Mohamed A. Soliman
van Zundert, Andre A. J.
Martens, Elisabeth J.
Schonberger, Jacques P. A. M.
de Wolf, Andre M.
Title Preoperative renal function as a predictor of survival after coronary artery bypass grafting: Comparison with a matched general population
Journal name Journal of Thoracic and Cardiovascular Surgery   Check publisher's open access policy
ISSN 0022-5223
1097-685X
Publication date 2009
Year available 2009
Sub-type Article (original research)
DOI 10.1016/j.jtcvs.2009.05.026
Open Access Status
Volume 138
Issue 4
Start page 971
End page 976
Total pages 6
Place of publication Philadelphia, PA United States
Publisher Mosby
Language eng
Abstract Objective: Preoperative renal dysfunction is an established risk factor for early and late mortality after revascularization. We studied how renal function affects long-term survival of patients after coronary artery bypass grafting. Methods: Early and late mortality were determined retrospectively among consecutive patients having isolated coronary bypass at a single Dutch institution between January 1998 and December 2007. Patients were stratified into 4 groups according to preoperative renal function. Expected survival was gauged using a general Dutch population group that was obtained from the database of the Dutch Central Bureau for Statistics; for each of our renal function groups, a general population group was assembled by matching for age, gender, and year of operation. Results: After excluding 122 patients lost to follow-up, 10,626 patients were studied; in 10,359, preoperative creatinine clearance could be calculated. Multivariate logistic regression and Cox regression analysis identified renal dysfunction as a predictor for early and late mortality. When long-term survival of patient groups was compared with expected survival, only patients with a creatinine clearance less than 30 mL · min-1 showed a worse outcome. Patients with a creatinine clearance between 60 and 90 mL · min-1 had a long-term survival exceeding the expected survival. Conclusions: Severity of renal dysfunction was related to poor survival. When compared with expected survival, however, patients having coronary bypass had a worse outcome only when severe preoperative renal dysfunction was present.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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Created: Wed, 20 May 2015, 09:59:53 EST by Andre Van Zundert on behalf of Anaesthesiology and Critical Care - RBWH