Predicting acute renal failure after coronary bypass surgery: Cross-validation of two risk-stratification algorithms

Fortescue, Elizabeth B.; Bates, David W.; Chertow, Glenn M.

doi:10.1046/j.1523-1755.2000.00119.x

Cited by 156 publications

(120 citation statements)

References 24 publications

Supporting

Mentioning

113

Contrasting

Unclassified

Order By: Relevance

“…Mortality ranges from 3.5% to 31.0% [5][6][7][8][9][10][11][12][16][17][18][19]23 , and this variation may be because of the criteria used for its diagnosis: the number and characteristics of hospitals involved in each study, the patients' features, and the size of the sample 11,24 . These aspects hinder data comparison among the several studies performed.…”

Section: Discussionmentioning

confidence: 99%

“…Acute renal failure requiring dialysis (acute renal failure-D) after cardiac surgery, occurs from 0.5% to 15.0% [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]23,26 . Its occurrence in our study was 4.9% (11 cases), greater than that reported in other studies, apart from that of Suen et al 15 and of OR -odds ratio; CI -confidence interval; ECC -extracorporeal circulation.…”

Section: Discussionmentioning

confidence: 99%

“…This rate was greater than that described in other studies, which remained between 1.3% and 22.3% [5][6][7][8]11,12,19,21 in patients with acute renal failure, and this incidence was correlated with a greater percentage of patients with acute renal failure-D, which has a higher mortality rate. However, the criteria that determined myocardial coronary artery bypass surgery (emergency or elective) related to a worse prognosis were not assessed in this study 15,17 .…”

Section: Discussionmentioning

confidence: 99%

“…In cardiac surgery, its incidence ranges from 3.5% to 31.0% [5][6][7][8][9][10][11][12] , and the need for dialysis occurs in 0.3% to 15.0% of cases [5][6][7][8][9][10][11][12][13][14][15][16][17][18] . The presence of acute renal failure in these patients increases the mortality rate from 0.4% to 4.4% to 1.3% to 22.3%, and when dialysis is required, these rates reach 25.0% to 88.9% [5][6][7][8][9][10][11][12][13][14][15][16][17][18] , making it an independent risk factor for mortality, according to Chertow et al 16 , and increasing 8-fold the death odds ratio among these patients.…”

mentioning

confidence: 99%

“…The presence of acute renal failure in these patients increases the mortality rate from 0.4% to 4.4% to 1.3% to 22.3%, and when dialysis is required, these rates reach 25.0% to 88.9% [5][6][7][8][9][10][11][12][13][14][15][16][17][18] , making it an independent risk factor for mortality, according to Chertow et al 16 , and increasing 8-fold the death odds ratio among these patients.…”

mentioning

confidence: 99%

See 4 more Smart Citations

Insuficiência renal aguda após cirurgia de revascularização miocárdica com circulação extracorpórea: incidência, fatores de risco e mortalidade

Santos¹,

Silveira²,

Maia³

et al. 2004

Arq. Bras. Cardiol.

View full text Add to dashboard Cite

150Acute renal failure is a severe condition that occurs in 2.0% to 7.0% of patients during hospital stay [1][2][3] . In 18.0% to 47.0% of cases, it is related to a surgical event, and acute tubular necrosis is the main type of lesion 1,2,4 . The great variation in the incidence of acute renal failure among the studies presents a multifactor profile, including different diagnostic criteria, such as the study design, inclusion and exclusion criteria, profile of the patients and of the centers involved in the sample, hindering study comparisons 5 .In cardiac surgery, its incidence ranges from 3.5% to 31.0% [5][6][7][8][9][10][11][12] , and the need for dialysis occurs in 0.3% to 15.0% of cases [5][6][7][8][9][10][11][12][13][14][15][16][17][18] . The presence of acute renal failure in these patients increases the mortality rate from 0.4% to 4.4% to 1.3% to 22.3%, and when dialysis is required, these rates reach 25.0% to 88.9% [5][6][7][8][9][10][11][12][13][14][15][16][17][18] , making it an independent risk factor for mortality, according to Chertow et al 16 , and increasing 8-fold the death odds ratio among these patients.The presence of conditions that determine hypoperfusion and renal ischemia are directly related to the development of ARF. Patients who present with reduced renal functional reserve, in whom a reduction occurs in the glomerular filtration rate without serum creatinine elevation above normal values, are more likely to have ARF even with minor renal lesions 16 . Preoperative and intraoperative factors, such as age, previous level of creatinine, diabetes mellitus, cardiac output, the duration of extracorporeal circulation, and the use of the intraaortic balloon, are influencial in the development of ARF [5][6][7][8][10][11][12]19 . The severity of ARF may increase with the occurrence of complications in the postoperative period, such as infections, hemorrhage, and the use of nephrotoxic substances 20 .In Brazil, few studies have reported the incidence of ARF after cardiac surgery, its risk factors, and its outcomes. The great impact of ARF in the outcomes of cardiac surgery demand its study in our population, encouraging to the elaboration of this study, which aims at identifying the incidence, risk factors, duration of ICU stay, and mortality due to ARF after myocardial coronary artery bypass surgery in a university hospital in Brazil. MethodsFrom 10/1/2001 to 9/30/2002, 223 of 247 patients undergoing myocardial coronary artery bypass surgery were prospectively studied. Exclusion criteria were: surgery without extracorporeal circulation (12 patients), death within the first 24h after surgery ConclusionAcute renal failure after myocardial coronary artery bypass surgery is a frequent complication associated with a high mortality rate. The independent risk factors are age, previous renal failure, and the need for inotropic drugs.

show abstract