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Comparative Study
. 2020 Mar:247:136-143.
doi: 10.1016/j.jss.2019.10.032. Epub 2019 Nov 27.

Postoperative Complications Are Not Elevated in Well-Compensated ESRD Patients Undergoing Cardiac Surgery: End-Stage Renal Disease Cardiac Surgery Outcomes

Benjamin R Griffin  1 , Patrick D Kohtz  2 , Michael Bronsert  3 , T Brett Reece  2 , Joseph C Cleveland Jr  2 , David A Fullerton  2 , Sarah Faubel  4 , Muhammad Aftab  5
Affiliations
Comparative Study

Postoperative Complications Are Not Elevated in Well-Compensated ESRD Patients Undergoing Cardiac Surgery: End-Stage Renal Disease Cardiac Surgery Outcomes

Benjamin R Griffin et al. J Surg Res. 2020 Mar.

Abstract

Background: Patients with end-stage renal disease (ESRD) are at high risk for cardiac disease requiring surgery, and have been shown to have increased surgical risks. There have been significant improvements in ESRD management, surgical techniques, and patient selection over the past 10 y. We evaluated rates of serious postoperative outcomes in stable, well-dialyzed patients with ESRD undergoing nonemergent cardiac surgery compared to the general cardiac surgery population.

Methods: In this propensity-score matched study, we evaluated 1451 adult patients who underwent nonemergent cardiac surgery at the University of Colorado Hospital (UCH) between 2011 and 2016. Patients with ESRD were compared to nonESRD patients. The primary outcome was a composite endpoint, including 30-d mortality, stroke, postoperative infection, and prolonged intensive care unit (ICU) length of stay (LOS).

Results: A total of 35 patients with ESRD met inclusion criteria. These select patients were younger with few comorbidities than the nonESRD population. There were no statistically significant differences in the composite outcome between ESRD and nonESRD patients in the propensity-matched analysis (OR 0.70, CI 0.29-1.72, P = 0.44). There were no significant differences or trends for in-hospital mortality, postoperative stroke, infection, ICU LOS, or hospital LOS between the patients with and without ESRD.

Conclusions: Stable ESRD patients undergoing nonemergent surgery are not at increased risk of major postoperative complications when compared to those without ESRD. Well-compensated ESRD patients should not be excluded from surgical consideration.

Keywords: 30-d mortality; Cardiac surgery; End-stage renal disease; Intensive care unit; Postoperative infection.

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Figures

Figure 1.
Figure 1.
Cohort selection flow diagram depicting patient screening and exclusions.
Figure 2.
Figure 2.
Forest Plot showing propensity-matched outcomes in ESRD vs. no ESRD patients.
See this image and copyright information in PMC

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References

    1. Saran R, Robinson B, Abbott KC et al. US Renal Data System 2016 Annual Data Report: Epidemiology of Kidney Disease in the United States. Am J Kidney Dis 2017; 69: A7–a8. - PMC - PubMed
    1. Rahman M, Xie D, Feldman HI et al. Association between chronic kidney disease progression and cardiovascular disease: results from the CRIC Study. Am J Nephrol 2014; 40: 399–407. - PMC - PubMed
    1. Cooper WA, Brinkman W, Petersen RJ, Guyton RA. Impact of renal disease in cardiovascular surgery: emphasis on the African-American patient. Ann Thorac Surg 2003; 76: S1370–1376. - PubMed
    1. Charytan DM, Li S, Liu J, Herzog CA. Risks of death and end-stage renal disease after surgical compared with percutaneous coronary revascularization in elderly patients with chronic kidney disease. Circulation 2012; 126: S164–169. - PMC - PubMed
    1. Doshi R, Shah J, Patel V et al. Transcatheter or surgical aortic valve replacement in patients with advanced kidney disease: A propensity score-matched analysis. Clin Cardiol 2017; 40: 1156–1162. - PMC - PubMed

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