title: Factors associated with early mortality in haemodialysis patients undergoing coronary artery bypass surgery.
abstract: BACKGROUND
  Coronary artery bypass grafting (CABG) results in higher morbidity and mortality rates in end-stage renal disease (ESRD) patient populations than in patients with normal renal function. This study aimed to identify the early results of CABG performed on ESRD patients, and the factors that affected the mortality rates of those patients.
  
  
  METHODS
  A retrospective evaluation of our hospital database revealed 84 haemodialysis-receiving patients who underwent CABG during the years 2006 to 2012. Mortality was observed in 21 patients (group 1), and this group was compared with the remaining patients (group 2) for peri-operative parameters such as age, EuroSCORE, functional capacity, myocardial infarction, use of inotropes and completeness of revascularisation.
  
  
  RESULTS
  The study included 60 male (71.4%) and 24 female patients (28.6%); the participants' mean age was 59.50 ± 9.93 years. The pre-operative additive EuroSCORE was 7.96 ± 2.88 (range: 2-18). Pre-operative functional capacity was impaired in 35.7% of the patients [New York Heart Association (NYHA) classes III-IV]. Mean age and preoperative EuroSCORE values of group 1 were significantly higher than those of group 2. Impaired functional capacity (NHYA classes III-IV) was also associated with mortality (OR: 3.333; 95% CI: 1.199-9.268). Fifty-four patients (64.3%) underwent on-pump CABG procedures, and 30 (35.7%) underwent off-pump CABG procedures. The study found no statistically significant difference in mortality rates between these two techniques. Mortality occurred in 12 patients (22.2%) in the on-pump group and in nine (30%) in the off-pump group. Complete revascularisation was performed on 46 patients (85.2%) in the on-pump group and seven (23.3%) in the off-pump group (p < 0.001).
  
  
  CONCLUSIONS
  Advanced age, impaired NYHA functional capacity and pre-operative hypertension were determinative for early-term surgical mortality. An on-pump surgical technique is recommended to ensure completeness of revascularisation.
authors.affiliation: Department of Cardiovascular Surgery, Kartal Koşuyolu Heart and Research Hospital, Istanbul, Turkey.
authors.forename: Deniz
authors.initials: D
authors.lastname: Çevirme
authors.affiliation: Department of Cardiovascular Surgery, Kartal Kosuyolu Heart and Research Hospital, Istanbul, Turkey. Email: taylanadademir@gmail.com.
authors.forename: Taylan
authors.initials: T
authors.lastname: Adademir
authors.affiliation: Department of Cardiovascular Surgery, Kartal Koşuyolu Heart and Research Hospital, Istanbul, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Aksüt
authors.affiliation: Department of Anesthesiology, Kartal Koşuyolu Heart and Research Hospital, Istanbul, Turkey.
authors.forename: Tülay
authors.initials: T
authors.lastname: Örki
authors.affiliation: Department of Cardiovascular Surgery, Kartal Kosuyolu Heart and Research Hospital, Istanbul, Turkey.
authors.forename: Kamil Cantürk
authors.initials: KC
authors.lastname: Çakalağaoğlu
authors.affiliation: Department of Cardiovascular Surgery, Kartal Koşuyolu Heart and Research Hospital, Istanbul, Turkey.
authors.forename: Mete
authors.initials: M
authors.lastname: Alp
authors.affiliation: Department of Cardiovascular Surgery, Kartal Koşuyolu Heart and Research Hospital, Istanbul, Turkey.
authors.forename: Kaan
authors.initials: K
authors.lastname: Kirali
mesh_terms: D000367:Age Factors; D000368:Aged; D002315:Cardiopulmonary Bypass / Q000009:adverse effects / Q000401:mortality; D016009:Chi-Square Distribution; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000401:mortality*; D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects / Q000401:mortality; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D016208:Databases, Factual; D005260:Female; D006801:Humans; D006973:Hypertension / Q000401:mortality; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D018579:Patient Selection; D006435:Renal Dialysis / Q000009:adverse effects / Q000401:mortality*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome