What question did this study set out to answer?

Assess whether preoperative mild-to-moderate renal dysfunction independently influences mechanical ventilation time and intensive care unit (ICU) length of stay following open-heart surgery.

June 7, 2007European Journal of Cardio-Thoracic Surgery

Mild and moderate renal dysfunction: impact on short-term outcome

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Why the study?

Does preoperative mild to moderate renal dysfunction increase ICU length of stay and mechanical ventilation time in patients undergoing open-heart surgery?

Population

156 consecutive patients undergoing open-heart surgery

Comparison

Preoperative creatinine clearance <70 ml/min vs Preoperative creatinine clearance >70 ml/min

Design

Cohort

Follow-up

short-term (ICU stay)

Authors

CSCaterina SimonInterventional / Structural Cardiology RLRemo LucianiAzienda Ospedaliera San Camillo-Forlanini FCFabio CapuanoSapienza University of Rome

Discussion

Member takes

Implication

Preoperative mild renal dysfunction may prolong ICU stay and ventilation after open-heart surgery; leaves open whether optimization improves outcomes.

Key Points

Assess whether preoperative mild-to-moderate renal dysfunction independently influences mechanical ventilation time and intensive care unit (ICU) length of stay following open-heart surgery.
Prospective study of 156 consecutive patients undergoing open-heart surgery at University Hospital St. Andrea in Rome.
Preoperative creatinine clearance (ClCr) was calculated via the Cockcroft-Gault formula to categorize patients into Group A (ClCr < 70 ml/min, n=78) and Group B (ClCr > 70 ml/min, n=78).
ICU length of stay was significantly longer in Group A (median 48 h, range 24–72) compared to Group B (median 24 h, range 20.7–44; p=0.0001), remaining an independent predictor alongside hypertension and COPD on multivariate analysis.
Mechanical ventilation time was prolonged in Group A (median 8 h, range 5.7–13.2) versus Group B (median 6 h, range 4–10; p=0.001), with ClCr < 70 ml/min and EuroSCORE identified as independent predictors.

Structured PICO

Does preoperative mild to moderate renal dysfunction increase ICU length of stay and mechanical ventilation time in patients undergoing open-heart surgery?

Population

156 consecutive patients undergoing open-heart surgery

Intervention

Preoperative creatinine clearance <70 ml/min (mild/moderate renal dysfunction)

Comparator

Preoperative creatinine clearance >70 ml/min

Outcome

ICU length of stay and mechanical ventilation time

Preoperative mild renal dysfunction is an independent predictor of increased ICU length of stay and mechanical ventilation time following open-heart surgery.

Cite This Study

Simon et al. (2007) studied this question.

synapsesocial.com/papers/6a74925e0081fe7b05dbdd1b https://doi.org/10.1016/j.ejcts.2007.04.032

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Implication

Preoperative mild renal dysfunction may prolong ICU stay and ventilation after open-heart surgery; leaves open whether optimization improves outcomes.