title: Mild renal failure is associated with adverse outcome after cardiac valve surgery.
abstract: The present study was performed to ascertain whether the presence of mild renal failure (defined as a serum creatinine concentration of 1. 5 to 3.0 mg/dL) is an independent risk factor for adverse outcome after cardiac valve surgery. An extensive set of preoperative and postoperative data was collected in 834 prospectively evaluated patients undergoing cardiac valve surgery at 14 Veterans Affairs Medical Centers. Univariate and multivariable analyses were performed to determine whether an independent association of mild renal dysfunction with adverse outcomes was present. Patients with mild renal failure had significantly greater 30-day mortality rates (P = 0.001; 16% versus 6%) and frequency of postoperative bleeding (P = 0.023; 16% versus 8%), respiratory complications (P = 0.02, 29% versus 16%), and cardiac complications (P = 0.002; 18% versus 7%) than patients with normal renal function (serum creatinine <1.5 mg/dL) when controlling for multiple other variables. The presence of a serum creatinine concentration of 1.5 to 3.0 mg/dL is significantly and independently associated with adverse outcomes after cardiac valve surgery.
authors.affiliation: Department of Veterans Affairs Medical Center, University of Colorado Health Sciences Center, Denver, USA.
authors.forename: R J
authors.initials: RJ
authors.lastname: Anderson
authors.forename: M
authors.initials: M
authors.lastname: O'Brien
authors.forename: S
authors.initials: S
authors.lastname: MaWhinney
authors.forename: C B
authors.initials: CB
authors.lastname: VillaNueva
authors.forename: T E
authors.initials: TE
authors.lastname: Moritz
authors.forename: G K
authors.initials: GK
authors.lastname: Sethi
authors.forename: W G
authors.initials: WG
authors.lastname: Henderson
authors.forename: K E
authors.initials: KE
authors.lastname: Hammermeister
authors.forename: F L
authors.initials: FL
authors.lastname: Grover
authors.forename: A L
authors.initials: AL
authors.lastname: Shroyer
mesh_terms: D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D001026:Coronary Artery Bypass; D003404:Creatinine / Q000097:blood; D017707:Erythrocyte Transfusion; D005260:Female; D006331:Heart Diseases / Q000209:etiology; D006351:Heart Valves / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D019106:Postoperative Hemorrhage / Q000209:etiology; D011446:Prospective Studies; D051437:Renal Insufficiency / Q000097:blood / Q000145:classification / Q000150:complications*; D012140:Respiratory Tract Diseases / Q000209:etiology; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D003404:Creatinine