Mortality trends associated with acute renal failure requiring dialysis after CABG surgery in the United States

  • Nicoara A
  • Patel U
  • Phillips-Bute B
 et al. 
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Abstract

BACKGROUND/AIMS: 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.

Author-supplied keywords

  • *Renal Dialysis
  • Acute Kidney Injury/epidemiology/*mortality
  • Coronary Artery Bypass/*adverse effects/mortality
  • Databases, Factual/statistics & numerical data
  • Female
  • Humans
  • Incidence
  • Inpatients
  • Male
  • Mortality/*trends
  • Regression Analysis
  • Survival Rate/trends
  • United States/epidemiology

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Authors

  • A Nicoara

  • U D Patel

  • B G Phillips-Bute

  • A D Shaw

  • M Stafford-Smith

  • C A Milano

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