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

Blood Purif. 2009;28(4):359-63. doi: 10.1159/000235856. Epub 2009 Sep 1.

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.

MeSH terms

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