Mild and moderate renal dysfunction: impact on short-term outcome.

BACKGROUND

Preoperative renal dysfunction is an important risk factor in cardiac surgery. Thus, the association between creatinine clearance (ClCr) and mechanical ventilation time and ICU length of stay, independent of other established preoperative risk indicators, was analyzed.

METHODS

In our study, 156 consecutive patients underwent open-heart surgery at the Department of Cardiac Surgery, University Hospital St. Andrea, Rome, and were prospectively studied for the relation between the ClCr, using the formula develop by Cockroft and Gault, and ICU length of stay and mechanical ventilation time. The 156 patients were divided into two groups in relation of ClCr: group A (n=78) ClCr<70 ml/min; group B (n=78) ClCr>70 ml/min.

RESULTS

In multivariate analysis, ICU length of stay was influenced by ClCr<70 ml/min, hypertension and COPD. ICU stay was median 48 h (range 24-72) in group A versus 24h (range 20.7-44) in group B (p=0.0001). In multivariate analysis, only ClCr<70 ml/min and EuroScore were associated with increasing VAM. VAM was median 8h (range 5.7-13.2) in group A versus 6h (range 4-10) in group B (p=0.001).

CONCLUSIONS

Our study demonstrates that after short-term outcome follow-up, preoperative mild renal dysfunction is an independent predictor of ICU length of stay and mechanical ventilation time.