Open AccessRisk analysis of dialysis-dependent patients who underwent coronary artery bypass grafting
Author(s) -
Han-Yan Li,
ChihHsiang Chang,
ChengChia Lee,
Victor ChienChia Wu,
DongYi Chen,
PaoHsien Chu,
KuoSheng Liu,
FengChun Tsai,
Pyng-Jing Lin,
Shaowei Chen
Publication year - 2017
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000008146
Subject(s) - medicine , dialysis , odds ratio , hemodialysis , confidence interval , peritoneal dialysis , stroke (engine) , coronary artery disease , mortality rate , surgery , retrospective cohort study , bypass grafting , cardiogenic shock , cardiology , artery , myocardial infarction , mechanical engineering , engineering
Cardiovascular disease is the major morbidity and leading cause of mortality for dialysis-dependent patients. This study aimed to stratify the risk factors and effects of dialysis modes in relation to coronary artery bypass grafting (CABG) surgery among dialysis-dependent patients. This retrospective study enrolled dialysis-dependent patients who underwent CABG from October 2005 to January 2015. All data of demographics, medical history, surgical details, postoperative complications, and in-hospital mortality were analyzed, and patients were categorized as those with or without in-hospital mortality and those with preoperative hemodialysis (HD) or peritoneal dialysis (PD). Of 134 enrolled patients, 25 (18.7%) had in-hospital mortality. Multivariate analyses identified that older age [odds ratio (OR): 1.110, 95% confidence interval (CI): 1.030–1.197, P = .006], previous stroke history (OR: 5.772, 95% CI: 1.643–20.275, P = .006), PD (OR: 19.607, 95% CI: 3.676–104.589, P < .001), and emergent operation (OR: 8.788, 95% CI: 2.697–28.636, P < .001) were statistically significant risk factors for in-hospital mortality among dialysis-dependent patients with CABG surgery. Patients with PD had a higher in-hospital mortality rate (58.3% vs 14.8%, P < .001) and lower 1-year overall survival (33.3% vs 56.6%, P = .031) than did HD patients. The major in-hospital mortality cause was cardiac events among HD patients and septic shock among PD patients. Among dialysis patients who received CABG, those with older age, previous stroke history, PD, and emergent operation had higher risks. Those with PD were prone to poorer in-hospital outcomes after CABG surgery.