Occult renal dysfunction: a mortality and morbidity risk factor in coronary artery bypass grafting surgery

Miceli, Antonio; Bruno, Vito Domenico; Capoun, Radek; Romeo, Francesco; Angelini, Gianni; Caputo, Massimo

doi:10.1016/j.jtcvs.2010.08.016

Cited by 28 publications

(22 citation statements)

References 23 publications

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“…Finally, renal impairment has been reported to increase the risk of morbidity and mortality after cardiac surgery 30 . In the current study, renal function was preserved in the majority, and we failed to identify eGFR as a potential predictor of readmission in either the univariable or multivariable regression analyses.…”

Section: Discussioncontrasting

confidence: 61%

Causes and characteristics associated with early and late readmission after open‐heart valve surgery

et al. 2020

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Objectives The objectives of the study were to describe the causes of readmission from discharge to 30 days and from day 31 to 180 after discharge and to investigate the characteristics associated with overall and cause‐specific readmissions after open‐heart valve surgery. Methods A single‐center, retrospective cohort of 980 patients undergoing open‐heart valve surgery from 2013 to 2016. Time to the first readmission was analyzed using univariable and multivariable Cox proportional hazard models. Results are reported as hazard ratios (HR) with 95% confidence intervals (CI). Results In total, 366 patients (37%) experienced unplanned cardiac readmission within 180 days after discharge. Within 30 days after discharge, the most frequent causes of readmission were pericardial/pleural effusions (n = 87), infections (n = 50), and atrial fibrillation/flutter (n = 45). Accordingly, infections (n = 32) were the most common cause from day 31 to 180. No powerful predictors of overall cardiac readmission were identified, but several characteristics were associated with cause‐specific readmissions: age ≤65 years (HR: 1.85; CI: 1.18‐2.88), male gender (HR: 1.85; CI: 1.11‐3.09), high alcohol intake (HR: 1.99; CI: 1.22‐3.24) and mitral valve procedures (HR: 1.86; CI: 1.11‐3.10) were associated with readmissions due to effusions. Ischemic heart disease with a prior percutaneous coronary intervention (HR: 2.94; CI: 1.53‐5.63), mitral valve procedures (HR: 2.10; CI: 1.23‐3.59), and postoperative atrial fibrillation/flutter (HR: 1.71; CI: 1.03‐2.85) were associated with atrial fibrillation/flutter readmissions. Conclusion Predicting overall readmissions after open‐heart valve surgery is difficult as causes of readmissions vary and different causes are associated with different characteristics. Future studies should target reducing cause‐specific readmissions.

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confidence: 61%

Causes and characteristics associated with early and late readmission after open‐heart valve surgery

et al. 2020

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“…The present findings indicate that renal failure is a major determinant of midterm survival in patients undergoing either SAVR or TAVI. Although the impact of subclinical renal failure in surgical patients is not new [19], this study suggests that only an eGFR less than 45 mL/min/1.73 m 2 has a negative prognostic impact in patients undergoing aortic valve replacement. Two previous studies confirm these findings [20][21][22] on the lack of prognostic impact of CKD stage 3a in patients undergoing aortic valve replacement and indicate, as originally observed by Go et al…”

Section: Commentmentioning

confidence: 73%

Transcatheter Aortic Valve Implantation Versus Surgical Aortic Valve Replacement for Severe Aortic Stenosis in Patients With Chronic Kidney Disease Stages 3b to 5

D’Errigo

Moretti

D’Ascenzo

et al. 2016

The Annals of Thoracic Surgery

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“…We call this condition occult renal insufficiency and it is usually defined as eGFR < 60 mL/min when creatinine is in normal range. Several studies have shown that the incidence of morbidity and mortality after cardiac surgery is higher in patients with occult renal insufficiency [50][51][52][53] .…”

Section: Preoperative Creatinine and Occult Renal Insufficiencymentioning

confidence: 99%

Serum creatinine role in predicting outcome after cardiac surgery beyond acute kidney injury

Najafi

2014

WJC

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Serum creatinine is still the most important determinant in the assessment of perioperative renal function and in the prediction of adverse outcome in cardiac surgery. Many biomarkers have been studied to date; still, there is no surrogate for serum creatinine measurement in clinical practice because it is feasible and inexpensive. High levels of serum creatinine and its equivalents have been the most important preoperative risk factor for postoperative renal injury. Moreover, creatinine is the mainstay in predicting risk models and risk factor reduction has enhanced its importance in outcome prediction. The future perspective is the development of new definitions and novel tools for the early diagnosis of acute kidney injury largely based on serum creatinine and a panel of novel biomarkers.

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Occult renal dysfunction: a mortality and morbidity risk factor in coronary artery bypass grafting surgery

Abstract: Occult renal dysfunction is an independent risk factor for early mortality and morbidity in patients undergoing coronary artery bypass grafting.

Cited by 28 publications

References 23 publications

Causes and characteristics associated with early and late readmission after open‐heart valve surgery

Causes and characteristics associated with early and late readmission after open‐heart valve surgery

Transcatheter Aortic Valve Implantation Versus Surgical Aortic Valve Replacement for Severe Aortic Stenosis in Patients With Chronic Kidney Disease Stages 3b to 5

Serum creatinine role in predicting outcome after cardiac surgery beyond acute kidney injury

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