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

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.

Duke Scholars

Author Alina Nicoara Anesthesiology, Cardiothoracic

Author Uptal Dinesh Patel Medicine, Nephrology

Author Mark Stafford-Smith Anesthesiology, Cardiothoracic

Author Carmelo Alessio Milano Surgery, Cardiovascular and Thoracic Surgery

Author Madhav Swaminathan Anesthesiology, Cardiothoracic