Effect of preoperative creatinine levels on mortality after coronary artery bypass grafting surgery: an observational study
Rev. bras. cir. cardiovasc
;
34(2): 149-155, Mar.-Apr. 2019. tab, graf
Article
Dans Anglais
| LILACS
| ID: biblio-990567
ABSTRACT
Abstract Introduction:
Renal function is an independent risk factor for mortality among on-pump coronary bypass grafting (ONCABG) patients. This association is well known in the international literature, but there is a lack of knowledge of how admission creatinine (AC) levels modulate each cardiovascular risk factor.Objective:
The aim of this paper was to assess the effect of different AC levels on mortality among ONCABG patients.Methods:
1,599 patients who underwent ONCABG between December 1999 and February 2006 at Hospital de Base in São José do Rio Preto/SP-Brazil were included. They were divided into quartiles according to their AC levels (QI 0.2 ≤AC < 1.0 mg/dL; QII 1.0 ≤ AC < 1.2 mg/dL; QIII 1.2 ≤ AC < 1.4 mg/dL; and QIV 1.4 ≤ AC ≤ 2.6 mg/dL). Seven risk factors were then evaluated in each stratum.Results:
Mortality was higher in the QIV group than QI or QII groups. Factors such as age (≥ 65 years) and cardiopulmonary bypass (CPB) time (≥ 115 minutes) in QIV, as well preoperative hospital stay (≥ 5 days) in QIII, were associated with higher mortality rates. Creatinine variation greater than or equal to 0.4 mg/dL increased mortality rates in all groups. The use of intra-aortic balloon pump and dialysis increased mortality rates in all groups except for QII. Type I neurological dysfunction increased the mortality rate in the QII and III groups.Conclusion:
Creatinine levels play an important role in ONCABG mortality. The combination of selected risk factors and higher AC values leads to a worse prognosis. On the other hand, lower AC values were associated with a protective effect, even among elderly patients and those with a high CPB time.
Texte intégral:
Disponible
Indice:
LILAS (Amériques)
Sujet Principal:
Pontage aortocoronarien
/
Créatinine
/
Période préopératoire
Type d'étude:
Etude d'étiologie
/
Étude observationnelle
/
Étude pronostique
/
Facteurs de risque
Limites du sujet:
Adulte très âgé
/
Femelle
/
Humains
/
Mâle
Pays comme sujet:
Amérique du Sud
/
Brésil
langue:
Anglais
Texte intégral:
Rev. bras. cir. cardiovasc
Thème du journal:
Cardiologie
/
Chirurgie générale
Année:
2019
Type:
Article
Pays d'affiliation:
Brésil
Institution/Pays d'affiliation:
Hospital Amecor/BR
/
Hospital Femina/BR
/
Hospital de Base São José do Rio Preto/BR
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