HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Claudius Diez Hans-Stefan Hofmann Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Diez, C. Articles by Hofmann, H.-S. Search for Related Content PubMed Articles by Diez, C. Articles by Hofmann, H.-S. Related Collections Cardiac - other

---

Original Articles: Adult Cardiac

Impact of Preoperative Renal Dysfunction on In-hospital Mortality After Solitary Valve and Combined Valve and Coronary Procedures

^a Department of Cardiothoracic Surgery, University Regensburg, Regensburg, Germany
^e Department of Thoracic Surgery, University Regensburg, Regensburg, Germany
^b Department of Internal Medicine II, Martin Luther University Halle-Wittenberg, Germany
^d Department of Cardiothoracic Surgery, Martin Luther University Halle-Wittenberg, Germany
^c Institute of Medical Epidemiology, Biostatistics, and Informatics, Halle (Saale), Germany

Accepted for publication November 17, 2008.

^_* Address correspondence to Dr Diez, University Hospital Regensburg, Department of Cardiothoracic Surgery, Franz-Josef-Strauß-Allee 11, Regensburg, D-93053, Germany (Email: claudius.diez{at}t-online.de).

Background: Limited information exists on the influence of preoperative renal dysfunction on in-hospital mortality after valve and combined valve and coronary procedures. The impact of preoperative renal dysfunction on patient outcome was investigated.

Methods: This was a retrospective observational study of 916 patients who underwent solitary valve or combined procedures. Primary outcome was in-hospital mortality. Preoperative estimated glomerular filtration rate (eGFR) was calculated with the abbreviated Modification of Diet in Renal Disease formula.

Results: Independent predictors of death were prolonged stay in the intensive care unit (odds ratio [OR], 1.03; 95% confidence interval [CI], 1.01 to 1.05), preoperative atrial fibrillation (OR, 1.61; 95% CI, 1.02 to 2.54), chronic obstructive pulmonary disease (OR, 2.2; 95% CI, 1.06 to 4.55), and prolonged operation time (OR, 1.01; 95% CI, 1.00 to 1.01). Each unit of the eGFR (mL/min/1.73m²) above average exerted a renoprotective effect (OR, 0.97; 95% CI, 0.96 to 0.98). The final regression model showed no lack of fit (Hosmer-Lemeshow test, p = 0.38) and a good discrimination performance in a receiver operating characteristic analysis (area under the curve, 0.84; 95% CI, 0.80 to 0.88). The lower the preoperative eGFR rate, the longer the postoperative stay at the intensive care unit.

Conclusions: Renal dysfunction is an important independent predictor of in-hospital mortality in adult patients after valve and combined valve and coronary procedures.

This article has been cited by other articles:

				R. Gunay, M. Bicer, Y. Sensoz, and M. M. Demirtas eComment: Factors related to bioprosthetic valve calcification in the elderly Interactive CardioVascular and Thoracic Surgery, November 1, 2009; 9(5): 846 - 846. [Full Text] [PDF]