Key result
Maintenance dialysis is linked to a ~7-day longer hospital stay and increased extracorporeal circulation.
Why the study?
To evaluate a multidisciplinary perioperative protocol aligned with guidelines for dialysis patients undergoing cardiac surgery by investigating perioperative complications.
Do patients on maintenance dialysis have worse perioperative outcomes compared to non-dialysis patients when undergoing cardiac surgery?
Cohort (n=128)
No
Do patients on maintenance dialysis have worse perioperative outcomes compared to non-dialysis patients when undergoing cardiac surgery?
Effect estimate: 30.7 days vs 23.3 days
Absolute Event Rate: 30.7% vs 23.3%
p-value: p=<0.05
Cardiac surgery in dialysis patients yields in-hospital mortality rates comparable to those of non-dialysis patients when managed with a structured protocol, though hospital stays remain longer.
Dialysis patients may need prolonged postoperative monitoring after cardiac surgery; leaves open whether structured protocols meaningfully alter mortality risk.
A perioperative protocol that followed the JSDT guidelines for cardiac surgery in dialysis patients was developed to improve interprofessional collaboration and patient care. We evaluated the perioperative protocol and surgical com-plications at our hospital. The subjects were 128 patients who underwent cardiac surgery between January 2016 and December 2018, excluding those who underwent concomitant aortic surgery. The subjects were divided into two groups； i.e., into those who were（dialysis group）and were not（control group； i.e., non(cid:514)dialysis group）on maintenance dialysis therapy. The dialysis and control group consisted of 29 and 99 patients, respectively. Aortic valve replacement and coronary artery bypass grafting were the most common forms of cardiac surgery, and they exhib-ited similar frequencies in both groups. There were 2（7％）and 3（3％）in(cid:514)hospital deaths in the dialysis and control groups, respectively. The postoperative
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Nakai et al. (2020) conducted a cohort in Cardiac surgery (n=128). Maintenance dialysis therapy vs. Non-dialysis was evaluated on Postoperative hospital stay (30.7 days vs 23.3 days, p=<0.05). Maintenance dialysis therapy was associated with a significantly longer postoperative hospital stay (30.7 vs 23.3 days) and a higher need for unplanned extracorporeal circulation (17% vs 1%).
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