Risk evaluation and midterm outcome of cardiac surgery in patients on dialysis.
The medical charts of 54 patients on maintenance dialysis who underwent cardiovascular surgery (37 elective and 17 urgent/emergency) from 1994 to 2004 were retrospectively analyzed. Thirty patients had coronary artery bypass grafting (17 elective and 13 urgent/emergency), 18 had valve replacement (16 elective and 2 urgent/emergency), and 6 underwent aortic surgery (4 elective and 2 urgent/emergency). The overall early mortality rate was 11.1%, comprising 2 patients (5.4%) who had elective operations and 4 (23.5%) who had urgent or emergency operations ( p = 0.049). The overall 5-year survival rate was 48.4%. The 5-year survival rate was 67.2% for elective surgery and 10.5% for urgent/emergency surgery ( p = 0.0001). The midterm clinical results after elective cardiovascular surgery were acceptable, whereas the results after urgent/emergency surgery were poor. For elective surgery, sufficient and detailed preoperative examinations might have contributed to the better operative outcome. Early diagnosis and consultation to avoid urgent/emergency operations in dialysis patients is recommended.
Boku
Noriko
N
Department of Surgery, Graduate School of Medicine, Yokohama City University, 3-9, Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan.
Masuda
Munetaka
M
Eto
Masataka
M
Nishida
Takahiro
T
Morita
Shigeki
S
Tominaga
Ryuji
R
D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000601:surgery*; D013504:Cardiovascular Surgical Procedures / Q000706:statistics & numerical data*; D015897:Comorbidity; D017558:Elective Surgical Procedures / Q000706:statistics & numerical data; D004638:Emergency Treatment / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D016896:Treatment Outcome