Key result
Preoperative serum creatinine levels >1.8 mg/dL in non-dialysis-dependent patients undergoing open-heart surgery were associated with a significantly increased risk of postoperative mortality (OR 2.0).
Why the study?
Does elevated preoperative serum creatinine predict postoperative morbidity and mortality in non-dialyzable patients undergoing open-heart surgery?
Cohort (n=1,033)
No
Does elevated preoperative serum creatinine predict postoperative morbidity and mortality in non-dialyzable patients undergoing open-heart surgery?
Odds Ratio: 2 (95% CI 1.3–3)
p-value: p=0.002
Elevated preoperative serum creatinine (>1.8 mg/dL) is a strong independent predictor of increased in-hospital morbidity and mortality in non-dialyzable patients undergoing open-heart surgery.
May aid preoperative risk stratification in open-heart surgery; leaves open whether renal optimization reduces mortality.
OBJECTIVE: To determine the impact of preoperative serum creatinine level in non-dialyzable patients on postoperative morbidity and mortality. METHODS: This is a prospective study, where serum creatinine was used to give primary assessment on renal function status preoperatively. This study includes 1,033 patients, who underwent coronary artery bypass grafting, or valve(s) operations. The study took place at Al-Hada Military Hospital, Taif, Kingdom of Saudi between May 2008 and January 2012. Data were statistically analyzed using Chi square (x2) test and multivariable logistic regression, to evaluate the postoperative morbidity and mortality risks associated with low serum creatinine levels. RESULTS: Postoperative mortality increased with high serum creatinine level >1.8 mg/dL (p</=0.0005). Multivariable logistic regression, adjusting for potentially confounding variables demonstrated that a creatinine level of more than 1.8 mg/dL was associated with increased risk of re-operation for bleeding, postoperative renal failure, prolonged ventilatory support, ICU stay, and total hospital stay. CONCLUSION: Perioperative serum creatinine is strongly related to post operative morbidity and mortality in open heart surgery. High serum creatinine in non-dialyzable patients can predict the increased morbidity and mortality after cardiac operations.
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Tamer H. Ezeldin (2013) conducted a cohort in Open-heart surgery (CABG or valve operations) (n=1,033). Preoperative serum creatinine >1.8 mg/dL vs. Preoperative serum creatinine <1.3 mg/dL was evaluated on Postoperative mortality (OR 2.0, 95% CI 1.3-3.0, p=0.002). Preoperative serum creatinine levels >1.8 mg/dL in non-dialysis-dependent patients undergoing open-heart surgery were associated with a significantly increased risk of postoperative mortality (OR 2.0).
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