Abstract | OBJECTIVE: DESIGN: Observational cohort study. SETTING: Tertiary care center. PATIENTS: INTERVENTIONS:
Acute kidney injury was defined as either requirement of dialysis or >/=50% decline in postoperative glomerular filtration rate but not requiring dialysis. We compared on- and off-pump surgeries and used propensity score matching to examine the effect of off-pump surgery on acute kidney injury and mortality. MEASUREMENTS AND MAIN RESULTS: We found that 2.6% on-pump and 1.2% off-pump patients developed acute kidney injury requiring dialysis among the 2,370 matched subjects (relative risk, 2.06; 95% confidence interval [CI], 1.36-3.36); 5.0% of on-pump patients suffered a >/=50% decline in glomerular filtration rate compared with 2.5% in off-pump group (relative risk, 2.00; 95% CI, 1.48-2.82). The mortality rate in the matched cohort was 2.3% for on-pump group vs. 0.6% in off-pump group (relative risk, 3.88; 95% CI, 2.29-9.50). Among matched patients with acute kidney injury, the risk of mortality was 13.14 (95% CI, 8.43-30.50) in patients requiring dialysis and 9.33 (95% CI, 4.83-19.00) in those with >/=50% decline in glomerular filtration rate but not requiring dialysis. CONCLUSIONS: Off-pump surgery is associated with a lower risk of developing acute kidney injury (regardless of its definition). The risk of mortality is incremental with worsening degrees of acute kidney injury. Lower risk of acute kidney injury may be one of the factors that offer a survival advantage after off-pump surgery.
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Authors | John Kevin Hix, Charuhas V Thakar, Ethan M Katz, Jean-Pierre Yared, Joseph Sabik, Emil P Paganini |
Journal | Critical care medicine
(Crit Care Med)
Vol. 34
Issue 12
Pg. 2979-83
(Dec 2006)
ISSN: 0090-3493 [Print] United States |
PMID | 17075372
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
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Topics |
- Acute Kidney Injury
(etiology, mortality, prevention & control)
- Aged
- Cohort Studies
- Coronary Artery Bypass
(adverse effects, methods, mortality)
- Creatinine
(blood)
- Female
- Glomerular Filtration Rate
- Humans
- Male
- Risk Factors
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