Preoperative renal function as a predictor of survival after coronary artery bypass grafting: Comparison with a matched general population

Albert H.M. van Straten, Mohamed A. Soliman Hamad*, André A.J. van Zundert, Elisabeth J. Martens, Jacques P.A.M. Schönberger, Andre M. de Wolf

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

19 Scopus citations

Abstract

Objective: Preoperative renal dysfunction is an established risk factor for early and late mortality after revascularization. We studied how renal function affects long-term survival of patients after coronary artery bypass grafting. Methods: Early and late mortality were determined retrospectively among consecutive patients having isolated coronary bypass at a single Dutch institution between January 1998 and December 2007. Patients were stratified into 4 groups according to preoperative renal function. Expected survival was gauged using a general Dutch population group that was obtained from the database of the Dutch Central Bureau for Statistics; for each of our renal function groups, a general population group was assembled by matching for age, gender, and year of operation. Results: After excluding 122 patients lost to follow-up, 10,626 patients were studied; in 10,359, preoperative creatinine clearance could be calculated. Multivariate logistic regression and Cox regression analysis identified renal dysfunction as a predictor for early and late mortality. When long-term survival of patient groups was compared with expected survival, only patients with a creatinine clearance less than 30 mL · min-1 showed a worse outcome. Patients with a creatinine clearance between 60 and 90 mL · min-1 had a long-term survival exceeding the expected survival. Conclusions: Severity of renal dysfunction was related to poor survival. When compared with expected survival, however, patients having coronary bypass had a worse outcome only when severe preoperative renal dysfunction was present.

Original languageEnglish (US)
Pages (from-to)971-976
Number of pages6
JournalJournal of Thoracic and Cardiovascular Surgery
Volume138
Issue number4
DOIs
StatePublished - Oct 2009

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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