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
en En
| LILACS
| ID: biblio-990567
Biblioteca responsable:
BR1.1
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.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
LILACS
Asunto principal:
Puente de Arteria Coronaria
/
Creatinina
/
Periodo Preoperatorio
Tipo de estudio:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Aged
/
Female
/
Humans
/
Male
País/Región como asunto:
America do sul
/
Brasil
Idioma:
En
Revista:
Rev. bras. cir. cardiovasc
Asunto de la revista:
CARDIOLOGIA
/
CIRURGIA GERAL
Año:
2019
Tipo del documento:
Article
País de afiliación:
Brasil
Pais de publicación:
Brasil