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Characterizing peritoneal dialysis catheter use in pediatric patients after cardiac surgery.
- Source :
-
The Journal of thoracic and cardiovascular surgery [J Thorac Cardiovasc Surg] 2013 Aug; Vol. 146 (2), pp. 334-8. Date of Electronic Publication: 2012 Nov 08. - Publication Year :
- 2013
-
Abstract
- Objective: Children who undergo cardiac surgery are at high risk for renal insufficiency and abdominal compartment syndrome. Peritoneal dialysis catheter (PDC) implantation is used in this population for abdominal decompression and access for dialysis. However, there is no consensus regarding PDC use, and the practice varies widely. This study was undertaken to assess associated factors, outcomes, and variability in the use of PDC in patients who have undergone cardiac surgery.<br />Methods: The cohort was obtained from the Kids' Inpatient Database, years 2006 and 2009. Patients who underwent cardiac surgery were included and the subset that underwent PDC implantation during the same hospitalization was identified. Univariable and multivariable analyses assessed factors associated with PDC and survival.<br />Results: A cohort of 28,259 patients underwent cardiac surgery, of whom 558 (2%) had PDCs placed. In the PDC group, 39.1% (n = 218) had acute renal failure whereas 3.5% or patients (n = 974) in the non-PDC group had acute renal failure. Among patients receiving PDC, mortality was 20.3% (n = 113; vs 3.4% overall mortality, n = 955). Excluding patients with acute renal failure, mortality remained 12% (n = 41) for the PDC group. Factors associated significantly with PDC placement in the overall cohort were younger age, greater surgical complexity, nonelective admission, hospital region, use of cardiopulmonary bypass, and acute renal failure.<br />Conclusions: Patients receiving PDC after cardiac surgery had 20% mortality, which remained 12% after excluding patients with acute renal failure. Given the variability in PDC use and poor outcomes, further research is needed to assess the possible benefit of earlier intervention for peritoneal access in this high-risk cohort.<br /> (Copyright © 2013 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.)
- Subjects :
- Acute Kidney Injury diagnosis
Acute Kidney Injury etiology
Acute Kidney Injury mortality
Adolescent
Age Factors
Cardiac Surgical Procedures mortality
Chi-Square Distribution
Child
Child, Preschool
Databases, Factual
Female
Humans
Infant
Infant, Newborn
Logistic Models
Male
Multivariate Analysis
Odds Ratio
Peritoneal Dialysis adverse effects
Peritoneal Dialysis mortality
Retrospective Studies
Risk Factors
Survival Analysis
Time Factors
Treatment Outcome
United States
Acute Kidney Injury therapy
Cardiac Surgical Procedures adverse effects
Catheters, Indwelling
Peritoneal Dialysis instrumentation
Subjects
Details
- Language :
- English
- ISSN :
- 1097-685X
- Volume :
- 146
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- The Journal of thoracic and cardiovascular surgery
- Publication Type :
- Academic Journal
- Accession number :
- 23142113
- Full Text :
- https://doi.org/10.1016/j.jtcvs.2012.10.009