Preoperative risk factors for the development of Acute Renal Failure in cardiac surgery
| Autor: | André Luis Balbi, Luís Cuadrado Martins, Antonio Sérgio Martins, Maria Cristina Pereira Lima, Ana Cláudia Kochi, Rubens Ramos de Andrade, Marcos Augusto de Moraes Silva |
|---|---|
| Přispěvatelé: | Universidade Estadual Paulista (Unesp) |
| Jazyk: | portugalština |
| Rok vydání: | 2007 |
| Předmět: |
Gynecology
medicine.medical_specialty Insuficiência renal aguda business.industry Preoperative risk General Medicine Complicações pós-operatórias Surgery Cardiac surgery Postoperative complications Renal insufficiency acute Medicine Procedimentos cirúrgicos cardíacos Cardiology and Cardiovascular Medicine business Cardiac surgical procedures |
| Zdroj: | Brazilian Journal of Cardiovascular Surgery, Volume: 22, Issue: 1, Pages: 33-40, Published: MAR 2007 Brazilian Journal of Cardiovascular Surgery v.22 n.1 2007 Brazilian Journal of Cardiovascular Surgery Sociedade Brasileira de Cirurgia Cardiovascular (SBCCV) instacron:SBCCV SciELO Repositório Institucional da UNESP Universidade Estadual Paulista (UNESP) instacron:UNESP |
| ISSN: | 0102-7638 |
| Popis: | Submitted by Guilherme Lemeszenski (guilherme@nead.unesp.br) on 2013-08-22T18:57:53Z No. of bitstreams: 1 S0102-76382007000100009.pdf: 42121 bytes, checksum: ac92893ad75c456bbb27ee9b3d2d25d1 (MD5) Made available in DSpace on 2013-08-22T18:57:53Z (GMT). No. of bitstreams: 1 S0102-76382007000100009.pdf: 42121 bytes, checksum: ac92893ad75c456bbb27ee9b3d2d25d1 (MD5) Previous issue date: 2007-03-01 Made available in DSpace on 2013-09-30T19:53:02Z (GMT). No. of bitstreams: 2 S0102-76382007000100009.pdf: 42121 bytes, checksum: ac92893ad75c456bbb27ee9b3d2d25d1 (MD5) S0102-76382007000100009.pdf.txt: 32715 bytes, checksum: a8a5101d1c89d710fd629e7e38e87f8c (MD5) Previous issue date: 2007-03-01 Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-20T13:32:27Z No. of bitstreams: 2 S0102-76382007000100009.pdf: 42121 bytes, checksum: ac92893ad75c456bbb27ee9b3d2d25d1 (MD5) S0102-76382007000100009.pdf.txt: 32715 bytes, checksum: a8a5101d1c89d710fd629e7e38e87f8c (MD5) Made available in DSpace on 2014-05-20T13:32:27Z (GMT). No. of bitstreams: 2 S0102-76382007000100009.pdf: 42121 bytes, checksum: ac92893ad75c456bbb27ee9b3d2d25d1 (MD5) S0102-76382007000100009.pdf.txt: 32715 bytes, checksum: a8a5101d1c89d710fd629e7e38e87f8c (MD5) Previous issue date: 2007-03-01 OBJETIVO:Avaliar os fatores de risco clínicos pré-cirurgicos para o desenvolvimento de Insuficiência Renal Aguda (IRA) em pacientes submetidos à cirurgia cardíaca. MÉTODO: Foram estudados, de modo prospectivo, 150 pacientes submetidos à cirurgia cardíaca, durante 21 meses consecutivos, havendo um leve predomínio de homens (57%), idade média de 56 ± 15 anos, sendo que 66% apresentavam insuficiência coronariana como principal diagnóstico e 34% valvulopatias. A mediana da creatinina sérica no período pré-operatório foi de 1,1 mg/dl. IRA foi definida como elevação de 30% da creatinina sérica basal. O protocolo de variáveis clínicas teve seu preenchimento iniciado 48 horas antes do procedimento cirúrgico e encerrado 48 horas após o mesmo, incluindo variáveis cardiológicas e não-cardiológicas, além de resultados laboratoriais. RESULTADOS: A IRA esteve presente em 34% dos casos. Após análise multivariada, presença de doença vascular periférica foi fator pré-operatório identificado. CONCLUSÃO: Os resultados obtidos nesse estudo permitiram sinalizar alguns fatores contributivos para o desenvolvimento de IRA em cirurgia cardíaca, o que pode possibilitar condutas clínicas simples para evitar a disfunção renal nestas situações e, conseqüentemente, redução da taxa de mortalidade. No presente trabalho, o tamanho da amostra talvez tenha impedido a identificação de outros fatores de risco significativos. OBJECTIVE: To evaluate clinical risk factors for the development of Acute Renal Failure (ARF) in patients who undergo cardiac surgery. METHOD: Over a period of 21 consecutive months, one hundred and fifty patients who underwent cardiac surgery were studied. There was a slight prevalence of men (57%) and the average age was 56 ± 14.8 years. Sixty-six percent presented with coronary artery disease as the main diagnosis and 34% valvular heart disease. The median preoperative serum creatinine was 1.1 mg/dL. ARF was defined as a 30% increase in serum creatinine above baseline. The protocol of clinical variables initiated 48 hours before the surgical procedure and finished 48 hours after it and included cardiological and non-cardiological variables and laboratory data. RESULTS: ARF was present in 34% of the cases. After multivariate analysis, being a man and the presence of peripheral vascular disease were identified as the preoperative factors. CONCLUSION: The results obtained in this study identified some risk factors for the development of ARF in cardiac surgery, suggesting simple clinical procedures that may prevent renal dysfunction in these situations and, consequently, reduce the mortality rate. In the present study, the sample size has possibly impeded the identification of other significant risk factors. UNESP HC Cirurgia Cardiovascular UNESP HC Nefrologia UNESP HC Psiquiatria UNESP HC Cirurgia Cardiovascular UNESP HC Nefrologia UNESP HC Psiquiatria |
| Databáze: | OpenAIRE |
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