title: Mortality trends associated with acute renal failure requiring dialysis after CABG surgery in the United States.
abstract: 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.
authors.affiliation: Division of Cardiothoracic Anesthesiology and Critical Care Medicine, Department of Anesthesiology, Duke University Medical Center, Durham, N.C. 27710, USA.
authors.forename: Alina
authors.initials: A
authors.lastname: Nicoara
authors.forename: Uptal D
authors.initials: UD
authors.lastname: Patel
authors.forename: Barbara G
authors.initials: BG
authors.lastname: Phillips-Bute
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Shaw
authors.forename: Mark
authors.initials: M
authors.lastname: Stafford-Smith
authors.forename: Carmelo A
authors.initials: CA
authors.lastname: Milano
authors.forename: Madhav
authors.initials: M
authors.lastname: Swaminathan
mesh_terms: 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