Chronic Kidney Disease is Associated with Poor Outcomes after Isolated Coronary Artery Bypass Grafting

Research output: Contribution to conferenceAbstractOtherpeer-review

Abstract

Purpose: To examine the effect of different stages of chronic kidney disease (CKD) on the postoperative mortality and complications after isolated coronary artery bypass grafting (CABG), using a large cohort from the Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) database. Methods: Data from 31,250 patients who underwent CABG between 2001 and 2011 was analysed. Following calculation of the preoperative glomerular filtration rate (eGFR) patients were classified into 5 stages of CKD: normal (eGFR > 90 ml/min/1.73m2), mild renal impairment (eGFR 60 to 89), moderate (eGFR 30 to 59), severe (eGFR < 30 ml/min/1.73m2) and dialysis dependent. The relationship between the stage and outcomes was analysed by univariate regression, and then by multivariable logistic and Cox regression using the known risk factors in the AusScore II model, a predictive model of 30-day mortality developed from the same database. Results: Almost 77% of isolated CABG cases had some degree ofCKD- mild 50.3%, moderate 22.7%, severe 2.3%, and dialysis-dependent 1.5%. Compared to patients with normal eGFR, the adjusted risk for 30-day mortality increased with stage of CKD from mild (1.8 fold, 95% CI: 1.3-2.6) to dialysis dependent (4.4 fold, 95% CI: 2.4-8.2). The return to OR, prolonged ventilation, prolonged hospital stay, sepsis and need for transfusion were all increased with the stage of CKD. Late survival also decreased with CKD stage, from 10-year survival of85%in normaleGFRto 45.5% for severeCKD.Patients on dialysis had a better outcome on some measures than those with severe CKD without dialysis. Conclusions: Poor kidney function was a strong independent predictor for 30-day mortality and for many postoperative complications. In addition, late survival was significantly reduced. The high frequency of CKD means that these findings should be considered in all discussions and decisions regarding CABG surgery.
Original languageEnglish
PagesS393
Number of pages1
DOIs
Publication statusPublished - 2017
Externally publishedYes
EventAustralian and New Zealand Society of Cardiac and Thoracic Surgeons Annual Scientific Meeting 2016 - Cairns Convention Centre, Cairns, Australia
Duration: 6 Nov 20169 Nov 2016

Conference

ConferenceAustralian and New Zealand Society of Cardiac and Thoracic Surgeons Annual Scientific Meeting 2016
Abbreviated titleANZSCTS 2016
CountryAustralia
CityCairns
Period6/11/169/11/16

Cite this

Cochrane, A., Alramadan, M. J. A., Reid, C. M., Tran, L., Smith, J. A., & Billah, B. (2017). Chronic Kidney Disease is Associated with Poor Outcomes after Isolated Coronary Artery Bypass Grafting. S393. Abstract from Australian and New Zealand Society of Cardiac and Thoracic Surgeons Annual Scientific Meeting 2016, Cairns, Australia. https://doi.org/10.1016/j.hlc.2017.03.115
Cochrane, Andrew ; Alramadan, Mohammed Jassim A ; Reid, Christopher M. ; Tran, Lavinia ; Smith, Julian A ; Billah, Baki. / Chronic Kidney Disease is Associated with Poor Outcomes after Isolated Coronary Artery Bypass Grafting. Abstract from Australian and New Zealand Society of Cardiac and Thoracic Surgeons Annual Scientific Meeting 2016, Cairns, Australia.1 p.
@conference{cb981cdaf5be4b84994ce9bca31eea07,
title = "Chronic Kidney Disease is Associated with Poor Outcomes after Isolated Coronary Artery Bypass Grafting",
abstract = "Purpose: To examine the effect of different stages of chronic kidney disease (CKD) on the postoperative mortality and complications after isolated coronary artery bypass grafting (CABG), using a large cohort from the Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) database. Methods: Data from 31,250 patients who underwent CABG between 2001 and 2011 was analysed. Following calculation of the preoperative glomerular filtration rate (eGFR) patients were classified into 5 stages of CKD: normal (eGFR > 90 ml/min/1.73m2), mild renal impairment (eGFR 60 to 89), moderate (eGFR 30 to 59), severe (eGFR < 30 ml/min/1.73m2) and dialysis dependent. The relationship between the stage and outcomes was analysed by univariate regression, and then by multivariable logistic and Cox regression using the known risk factors in the AusScore II model, a predictive model of 30-day mortality developed from the same database. Results: Almost 77{\%} of isolated CABG cases had some degree ofCKD- mild 50.3{\%}, moderate 22.7{\%}, severe 2.3{\%}, and dialysis-dependent 1.5{\%}. Compared to patients with normal eGFR, the adjusted risk for 30-day mortality increased with stage of CKD from mild (1.8 fold, 95{\%} CI: 1.3-2.6) to dialysis dependent (4.4 fold, 95{\%} CI: 2.4-8.2). The return to OR, prolonged ventilation, prolonged hospital stay, sepsis and need for transfusion were all increased with the stage of CKD. Late survival also decreased with CKD stage, from 10-year survival of85{\%}in normaleGFRto 45.5{\%} for severeCKD.Patients on dialysis had a better outcome on some measures than those with severe CKD without dialysis. Conclusions: Poor kidney function was a strong independent predictor for 30-day mortality and for many postoperative complications. In addition, late survival was significantly reduced. The high frequency of CKD means that these findings should be considered in all discussions and decisions regarding CABG surgery.",
author = "Andrew Cochrane and Alramadan, {Mohammed Jassim A} and Reid, {Christopher M.} and Lavinia Tran and Smith, {Julian A} and Baki Billah",
year = "2017",
doi = "10.1016/j.hlc.2017.03.115",
language = "English",
pages = "S393",
note = "Australian and New Zealand Society of Cardiac and Thoracic Surgeons Annual Scientific Meeting 2016, ANZSCTS 2016 ; Conference date: 06-11-2016 Through 09-11-2016",

}

Cochrane, A, Alramadan, MJA, Reid, CM, Tran, L, Smith, JA & Billah, B 2017, 'Chronic Kidney Disease is Associated with Poor Outcomes after Isolated Coronary Artery Bypass Grafting' Australian and New Zealand Society of Cardiac and Thoracic Surgeons Annual Scientific Meeting 2016, Cairns, Australia, 6/11/16 - 9/11/16, pp. S393. https://doi.org/10.1016/j.hlc.2017.03.115

Chronic Kidney Disease is Associated with Poor Outcomes after Isolated Coronary Artery Bypass Grafting. / Cochrane, Andrew; Alramadan, Mohammed Jassim A; Reid, Christopher M.; Tran, Lavinia; Smith, Julian A; Billah, Baki.

2017. S393 Abstract from Australian and New Zealand Society of Cardiac and Thoracic Surgeons Annual Scientific Meeting 2016, Cairns, Australia.

Research output: Contribution to conferenceAbstractOtherpeer-review

TY - CONF

T1 - Chronic Kidney Disease is Associated with Poor Outcomes after Isolated Coronary Artery Bypass Grafting

AU - Cochrane, Andrew

AU - Alramadan, Mohammed Jassim A

AU - Reid, Christopher M.

AU - Tran, Lavinia

AU - Smith, Julian A

AU - Billah, Baki

PY - 2017

Y1 - 2017

N2 - Purpose: To examine the effect of different stages of chronic kidney disease (CKD) on the postoperative mortality and complications after isolated coronary artery bypass grafting (CABG), using a large cohort from the Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) database. Methods: Data from 31,250 patients who underwent CABG between 2001 and 2011 was analysed. Following calculation of the preoperative glomerular filtration rate (eGFR) patients were classified into 5 stages of CKD: normal (eGFR > 90 ml/min/1.73m2), mild renal impairment (eGFR 60 to 89), moderate (eGFR 30 to 59), severe (eGFR < 30 ml/min/1.73m2) and dialysis dependent. The relationship between the stage and outcomes was analysed by univariate regression, and then by multivariable logistic and Cox regression using the known risk factors in the AusScore II model, a predictive model of 30-day mortality developed from the same database. Results: Almost 77% of isolated CABG cases had some degree ofCKD- mild 50.3%, moderate 22.7%, severe 2.3%, and dialysis-dependent 1.5%. Compared to patients with normal eGFR, the adjusted risk for 30-day mortality increased with stage of CKD from mild (1.8 fold, 95% CI: 1.3-2.6) to dialysis dependent (4.4 fold, 95% CI: 2.4-8.2). The return to OR, prolonged ventilation, prolonged hospital stay, sepsis and need for transfusion were all increased with the stage of CKD. Late survival also decreased with CKD stage, from 10-year survival of85%in normaleGFRto 45.5% for severeCKD.Patients on dialysis had a better outcome on some measures than those with severe CKD without dialysis. Conclusions: Poor kidney function was a strong independent predictor for 30-day mortality and for many postoperative complications. In addition, late survival was significantly reduced. The high frequency of CKD means that these findings should be considered in all discussions and decisions regarding CABG surgery.

AB - Purpose: To examine the effect of different stages of chronic kidney disease (CKD) on the postoperative mortality and complications after isolated coronary artery bypass grafting (CABG), using a large cohort from the Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) database. Methods: Data from 31,250 patients who underwent CABG between 2001 and 2011 was analysed. Following calculation of the preoperative glomerular filtration rate (eGFR) patients were classified into 5 stages of CKD: normal (eGFR > 90 ml/min/1.73m2), mild renal impairment (eGFR 60 to 89), moderate (eGFR 30 to 59), severe (eGFR < 30 ml/min/1.73m2) and dialysis dependent. The relationship between the stage and outcomes was analysed by univariate regression, and then by multivariable logistic and Cox regression using the known risk factors in the AusScore II model, a predictive model of 30-day mortality developed from the same database. Results: Almost 77% of isolated CABG cases had some degree ofCKD- mild 50.3%, moderate 22.7%, severe 2.3%, and dialysis-dependent 1.5%. Compared to patients with normal eGFR, the adjusted risk for 30-day mortality increased with stage of CKD from mild (1.8 fold, 95% CI: 1.3-2.6) to dialysis dependent (4.4 fold, 95% CI: 2.4-8.2). The return to OR, prolonged ventilation, prolonged hospital stay, sepsis and need for transfusion were all increased with the stage of CKD. Late survival also decreased with CKD stage, from 10-year survival of85%in normaleGFRto 45.5% for severeCKD.Patients on dialysis had a better outcome on some measures than those with severe CKD without dialysis. Conclusions: Poor kidney function was a strong independent predictor for 30-day mortality and for many postoperative complications. In addition, late survival was significantly reduced. The high frequency of CKD means that these findings should be considered in all discussions and decisions regarding CABG surgery.

U2 - 10.1016/j.hlc.2017.03.115

DO - 10.1016/j.hlc.2017.03.115

M3 - Abstract

SP - S393

ER -

Cochrane A, Alramadan MJA, Reid CM, Tran L, Smith JA, Billah B. Chronic Kidney Disease is Associated with Poor Outcomes after Isolated Coronary Artery Bypass Grafting. 2017. Abstract from Australian and New Zealand Society of Cardiac and Thoracic Surgeons Annual Scientific Meeting 2016, Cairns, Australia. https://doi.org/10.1016/j.hlc.2017.03.115