What question did this study set out to answer?

To evaluate short- and long-term surgical outcomes following isolated coronary artery bypass grafting in non-dialysis-dependent patients with elevated serum creatinine levels.

September 1, 2001European Journal of Cardio-Thoracic SurgeryOpen Access

Coronary artery bypass grafting for patients with non-dialysis-dependent renal dysfunction (serum creatinine ≧2.0 mg/dl)

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Why the study?

Does non-dialysis-dependent renal dysfunction (serum creatinine ≥2.0 mg/dl) worsen perioperative and long-term outcomes in patients undergoing isolated CABG?

Population

1,725 consecutive patients undergoing isolated coronary artery bypass grafting, including 59 with…

Comparison

Isolated coronary artery bypass grafting in… vs Isolated CABG in control patients with serum…

Design

Cohort

Follow-up

mean 2.4 years

Authors

HHHitoshi HiroseCleveland Clinic AAAtushi AmanoShowa University ATAkihito TakahashiKurashiki Central Hospital

Discussion

Member takes

Implication

Renal dysfunction was associated with higher CABG mortality and lower survival; extends observational risk data but leaves open prospective validation.

Key Points

To evaluate short- and long-term surgical outcomes following isolated coronary artery bypass grafting in non-dialysis-dependent patients with elevated serum creatinine levels.
Retrospectively analyzed consecutive patients undergoing isolated CABG between May 1, 1991, and April 31, 2000, at Shin-Tokyo Hospital.
Compared outcomes between non-dialysis patients with preoperative serum creatinine ≥2.0 mg/dl (group R, n=59) and control patients with creatinine <2.0 mg/dl (group C, n=1666).
Subdivided group R into on-pump versus off-pump CABG cohorts to evaluate perioperative recovery profiles over a mean follow-up duration of 2.4 years.
Group R demonstrated higher rates of major postoperative complications (28.8% vs. 10.7%, P<0.0001) and in-hospital mortality (6.8% vs. 0.5%, P<0.0005) compared to group C.
Off-pump CABG in group R was associated with relatively faster recovery times compared to on-pump CABG.
Excluding hospital mortality, the actuarial 3-year survival rate was 75.3% in group R versus 96.9% in group C (P<0.0001), and the 3-year cardiac event-free rate was 76.7% versus 87.3% (P<0.05).

Structured PICO

Does non-dialysis-dependent renal dysfunction (serum creatinine ≥2.0 mg/dl) worsen perioperative and long-term outcomes in patients undergoing isolated CABG?

Population

1,725 consecutive patients undergoing isolated coronary artery bypass grafting (CABG), including 59 with non-dialysis-dependent renal dysfunction (serum creatinine ≥2.0 mg/dl, mean age 66.4, 51 males) and 1,666 controls (serum creatinine <2.0 mg/dl).

Intervention

Isolated coronary artery bypass grafting (CABG) in patients with non-dialysis-dependent renal dysfunction (serum creatinine ≥2.0 mg/dl).

Comparator

Isolated CABG in control patients with serum creatinine <2.0 mg/dl.

Outcome

Major complications, hospital mortality, 3-year survival rate, and 3-year cardiac event-free rate.hard clinical

Non-dialysis-dependent renal dysfunction significantly increases perioperative morbidity and mortality, and reduces long-term survival following isolated CABG.

Cite This Study

Hirose et al. (2001) studied this question.

synapsesocial.com/papers/6a8a824cd88561daf2cc1633 https://doi.org/10.1016/s1010-7940(01)00839-9

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Implication

Renal dysfunction was associated with higher CABG mortality and lower survival; extends observational risk data but leaves open prospective validation.

Coronary artery bypass grafting for patients with non-dialysis-dependent renal dysfunction (serum creatinine ≧2.0 mg/dl)

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Coronary artery bypass grafting for patients with non-dialysis-dependent renal dysfunction (serum creatinine ≧2.0 mg/dl)

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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Also Consider