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Mortality Trends Associated with Acute Renal Failure Requiring Dialysis after CABG Surgery in the United States

Nicoara A.a · Patel U.D.b · Phillips-Bute B.G.a · Shaw A.D.a · Stafford-Smith M.a · Milano C.A.c · Swaminathan M.a
aDivision of Cardiothoracic Anesthesiology and Critical Care Medicine, Department of Anesthesiology, bDivision of Nephrology, Department of Medicine, and Duke Clinical Research Institute, and cDivision of Thoracic Surgery, Department of Surgery, Duke University Medical Center, Durham, N.C., USA Blood Purif 2009;28:359–363 (DOI:10.1159/000235856)

Abstract

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.

 

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