Mortality trends associated with acute renal failure requiring dialysis after CABG surgery in the United States.

Nicoara A, Patel UD, Phillips-Bute BG, Shaw AD, Stafford-Smith M, Milano CA, Swaminathan M
Blood Purif. 2009 28 (4): 359-63

PMID: 19729906 · DOI:10.1159/000235856

BACKGROUND/AIMS - Acute renal failure is associated with a high risk of mortality when it complicates coronary artery bypass graft (CABG) surgery. We examined a large nationwide database from 1988 to 2003 and hypothesized that mortality in CABG-associated acute renal failure needing dialysis (ARF-D) had declined during this period.

METHODS - The Nationwide Inpatient Sample containing data on inpatient stays across 20% of US hospitals was used for our study. Multivariate logistic regression was used to determine an association between year and ARF-D mortality with standardized risk adjustment.

RESULTS - Incidence of ARF-D increased from 0.2 to 0.6% while mortality simultaneously decreased from 47.4% in 1988 to 29.7% in 2003. In the multivariable model, year was significantly associated with declining ARF-D mortality.

CONCLUSIONS - The incidence of post-CABG ARF-D more than doubled from 1988 to 2003, while mortality simultaneously decreased by over one-third. Improved survival after ARF-D following CABG may be counterbalanced by increased morbidity and resource utilization.

Copyright 2009 S. Karger AG, Basel.

MeSH Terms (13)

Acute Kidney Injury Coronary Artery Bypass Databases, Factual Female Humans Incidence Inpatients Male Mortality Regression Analysis Renal Dialysis Survival Rate United States

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