| Autor: |
Marcos Aurélio Barboza de Oliveira, Carlos Alberto dos Santos, Antônio Carlos Brandi, Ana Helena Dotta, Paulo Henrique Husseini Botelho, Moacir Fernandes de Godoy, Domingo M. Braile |
| Jazyk: |
angličtina |
| Předmět: |
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| Zdroj: |
Brazilian Journal of Cardiovascular Surgery, Vol 34, Iss 2, Pp 149-155 |
| Druh dokumentu: |
article |
| ISSN: |
1678-9741 |
| DOI: |
10.21470/1678-9741-2018-0261 |
| Popis: |
Abstract Introduction: Renal function is an independent risk factor for mortality among on-pump coronary bypass grafting (ONCABG) patients. This association is well known in the international literature, but there is a lack of knowledge of how admission creatinine (AC) levels modulate each cardiovascular risk factor. Objective: The aim of this paper was to assess the effect of different AC levels on mortality among ONCABG patients. Methods: 1,599 patients who underwent ONCABG between December 1999 and February 2006 at Hospital de Base in São José do Rio Preto/SP-Brazil were included. They were divided into quartiles according to their AC levels (QI: 0.2 ≤AC < 1.0 mg/dL; QII: 1.0 ≤ AC < 1.2 mg/dL; QIII: 1.2 ≤ AC < 1.4 mg/dL; and QIV: 1.4 ≤ AC ≤ 2.6 mg/dL). Seven risk factors were then evaluated in each stratum. Results: Mortality was higher in the QIV group than QI or QII groups. Factors such as age (≥ 65 years) and cardiopulmonary bypass (CPB) time (≥ 115 minutes) in QIV, as well preoperative hospital stay (≥ 5 days) in QIII, were associated with higher mortality rates. Creatinine variation greater than or equal to 0.4 mg/dL increased mortality rates in all groups. The use of intra-aortic balloon pump and dialysis increased mortality rates in all groups except for QII. Type I neurological dysfunction increased the mortality rate in the QII and III groups. Conclusion: Creatinine levels play an important role in ONCABG mortality. The combination of selected risk factors and higher AC values leads to a worse prognosis. On the other hand, lower AC values were associated with a protective effect, even among elderly patients and those with a high CPB time. |
| Databáze: |
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| Externí odkaz: |
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