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Risk analysis of dialysis-dependent patients who underwent coronary artery bypass grafting: Effects of dialysis modes on outcomes.
- Source :
-
Medicine [Medicine (Baltimore)] 2017 Sep; Vol. 96 (39), pp. e8146. - Publication Year :
- 2017
-
Abstract
- Cardiovascular disease is the major morbidity and leading cause of mortality for dialysis-dependent patients. This study aimed to stratify the risk factors and effects of dialysis modes in relation to coronary artery bypass grafting (CABG) surgery among dialysis-dependent patients.This retrospective study enrolled dialysis-dependent patients who underwent CABG from October 2005 to January 2015. All data of demographics, medical history, surgical details, postoperative complications, and in-hospital mortality were analyzed, and patients were categorized as those with or without in-hospital mortality and those with preoperative hemodialysis (HD) or peritoneal dialysis (PD).Of 134 enrolled patients, 25 (18.7%) had in-hospital mortality. Multivariate analyses identified that older age [odds ratio (OR): 1.110, 95% confidence interval (CI): 1.030-1.197, P = .006], previous stroke history (OR: 5.772, 95% CI: 1.643-20.275, P = .006), PD (OR: 19.607, 95% CI: 3.676-104.589, P < .001), and emergent operation (OR: 8.788, 95% CI: 2.697-28.636, P < .001) were statistically significant risk factors for in-hospital mortality among dialysis-dependent patients with CABG surgery. Patients with PD had a higher in-hospital mortality rate (58.3% vs 14.8%, P < .001) and lower 1-year overall survival (33.3% vs 56.6%, P = .031) than did HD patients. The major in-hospital mortality cause was cardiac events among HD patients and septic shock among PD patients.Among dialysis patients who received CABG, those with older age, previous stroke history, PD, and emergent operation had higher risks. Those with PD were prone to poorer in-hospital outcomes after CABG surgery.
- Subjects :
- Age Factors
Aged
Female
Hospital Mortality
Humans
Male
Middle Aged
Outcome Assessment, Health Care
Retrospective Studies
Risk Factors
Stroke epidemiology
Taiwan epidemiology
Coronary Artery Bypass adverse effects
Coronary Artery Bypass methods
Coronary Artery Disease complications
Coronary Artery Disease mortality
Coronary Artery Disease surgery
Kidney Failure, Chronic complications
Kidney Failure, Chronic therapy
Peritoneal Dialysis adverse effects
Peritoneal Dialysis methods
Postoperative Complications epidemiology
Renal Dialysis adverse effects
Renal Dialysis methods
Risk Assessment methods
Subjects
Details
- Language :
- English
- ISSN :
- 1536-5964
- Volume :
- 96
- Issue :
- 39
- Database :
- MEDLINE
- Journal :
- Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 28953653
- Full Text :
- https://doi.org/10.1097/MD.0000000000008146