当前位置： SCI文献检索 > EXPERIMENTAL GERONTOLOGY期刊下所有文献 > Preoperative renal dysfunction and clinical outcomes of cardiac surgery in octogenarians.

Preoperative renal dysfunction and clinical outcomes of cardiac surgery in octogenarians.

Abstract：

BACKGROUND:The proportion of elderly individuals is growing and the prevalence of chronic kidney disease (CKD) among elderly people undergoing cardiac surgery is increasing constantly. The aim of this study was to determine the influence of different degrees of preoperative renal dysfunction on postoperative outcomes in patients older than 80years of age. METHODS:This is an observational study that included adult patients undergoing cardiac surgery in which data were collected prospectively. Patients were divided into groups according to their preoperative plasma creatinine and eGFR levels. RESULTS:From February 1997 to January 2010, 318 octogenarians underwent cardiac surgery. Of these, 140 patients (44%) had abnormal preoperative creatinine levels. A significantly higher incidence of postoperative sepsis (4% vs. 17%, p 0.03), CVA (1% vs. 6%, p 0.03), and prolonged hospital stay (16±13 vs. 20±16days, p 0.04) were detected in patients with preoperative kidney dysfunction. Subgroup analysis revealed that preoperative CKD stage IV (eGFR 15-30ml/min/1.73m(2)) but not CKD stage III (eGFR 30-60ml/min/1.73m(2)) and preoperative creatinine >1.8mg/dl were independently associated with increased incidence of postoperative CVA (OR 4; 95% CI 0.07-0. 8, p=0.05 for eGFR, and OR 7.8; 95% CI 1.2-60, p=0.003 for creatinine). However, no significant increment in postoperative mortality with decreasing eGFR or increasing preoperative creatinine was demonstrated. CONCLUSIONS:A substantial increase in the risk of postoperative CVA and sepsis, but not mortality, was demonstrated in octogenarians with advanced but not mild degrees of preoperative CKD. Compared to younger patients, a high burden of comorbidities in octogenarians may have a greater influence on outcomes post cardiac surgery than impaired renal function. Our data may provide a rationale for modified risk stratification in octogenarian candidates for cardiac surgery.

journal_name

Exp Gerontol

journal_title

Experimental gerontology

authors

Shavit L,Lifschitz M,Slotki I,Oren A,Tauber R,Bitran D,Fink D

doi

10.1016/j.exger.2013.01.012

subject

Has Abstract

pub_date

2013-03-01 00:00:00

pages

364-70

issue

eissn

0531-5565

issn

1873-6815

pii

S0531-5565(13)00027-2

journal_volume

pub_type

杂志文章

在线工具

Preoperative renal dysfunction and clinical outcomes of cardiac surgery in octogenarians.