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

Benjamin R. Griffin; Patrick D. Kohtz; Michael Bronsert; T. Brett Reece; Joseph C. Cleveland; David A. Fullerton; Sarah Faubel; Muhammad Aftab

doi:10.1016/j.jss.2019.10.032

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

Journal article

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

Benjamin R. Griffin, Patrick D. Kohtz, Michael Bronsert, T. Brett Reece, Joseph C. Cleveland, David A. Fullerton, Sarah Faubel and Muhammad Aftab

The Journal of surgical research, Vol.247, pp.136-143

03/2020

DOI: 10.1016/j.jss.2019.10.032

PMCID: PMC7192065

PMID: 31785887

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https://www.ncbi.nlm.nih.gov/pmc/articles/7192065View

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Abstract

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. 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). 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. 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.

30-d mortality

Cardiac surgery

End-stage renal disease

Intensive care unit

Postoperative infection

Details

Title: Subtitle: Postoperative Complications Are Not Elevated in Well-Compensated ESRD Patients Undergoing Cardiac Surgery: End-Stage Renal Disease Cardiac Surgery Outcomes
Creators: Benjamin R. Griffin - University of Iowa
Patrick D. Kohtz - University of Colorado Denver
Michael Bronsert - Outcomes Research Consortium
T. Brett Reece - University of Colorado Denver
Joseph C. Cleveland - University of Colorado Denver
David A. Fullerton - University of Colorado Denver
Sarah Faubel - University of Colorado Anschutz Medical Campus
Muhammad Aftab - Division of Cardiothoracic Surgery, University of Colorado School of Medicine, Aurora, Colorado
Resource Type: Journal article
Publication Details: The Journal of surgical research, Vol.247, pp.136-143
DOI: 10.1016/j.jss.2019.10.032
PMID: 31785887
PMCID: PMC7192065
NLM abbreviation: J Surg Res
ISSN: 0022-4804
eISSN: 1095-8673
Publisher: Elsevier Inc
Grant note: DOI: 10.13039/100014450, name: Anschutz Medical Campus, University of Colorado
Language: English
Date published: 03/2020
Academic Unit: Nephrology; Internal Medicine
Record Identifier: 9984360043102771

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