Mortality trends associated with acute renal failure requiring dialysis after CABG surgery in the United States.
OBJECTIVE
Acute renal failure is associated with a high risk of mortality when it complicates coronary artery bypass graft (CABG) surgery. We examined a large nationwide database from 1988 to 2003 and hypothesized that mortality in CABG-associated acute renal failure needing dialysis (ARF-D) had declined during this period.


METHODS
The Nationwide Inpatient Sample containing data on inpatient stays across 20% of US hospitals was used for our study. Multivariate logistic regression was used to determine an association between year and ARF-D mortality with standardized risk adjustment.


RESULTS
Incidence of ARF-D increased from 0.2 to 0.6% while mortality simultaneously decreased from 47.4% in 1988 to 29.7% in 2003. In the multivariable model, year was significantly associated with declining ARF-D mortality.


CONCLUSIONS
The incidence of post-CABG ARF-D more than doubled from 1988 to 2003, while mortality simultaneously decreased by over one-third. Improved survival after ARF-D following CABG may be counterbalanced by increased morbidity and resource utilization.
Nicoara
Alina
A
Division of Cardiothoracic Anesthesiology and Critical Care Medicine, Department of Anesthesiology, Duke University Medical Center, Durham, N.C. 27710, USA.
Patel
Uptal D
UD
Phillips-Bute
Barbara G
BG
Shaw
Andrew D
AD
Stafford-Smith
Mark
M
Milano
Carmelo A
CA
Swaminathan
Madhav
M
D058186:Acute Kidney Injury / Q000453:epidemiology / Q000401:mortality*; D001026:Coronary Artery Bypass / Q000009:adverse effects* / Q000401:mortality; D016208:Databases, Factual / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D015994:Incidence; D007297:Inpatients; D008297:Male; D009026:Mortality / Q000639:trends*; D012044:Regression Analysis; D006435:Renal Dialysis; D015996:Survival Rate / Q000639:trends; D014481:United States / Q000453:epidemiology