Main Organiser

Julius Centre University of Malaya

Co-organiser

Department of Social and Preventive Medicine, Faculty of Medicine, University of Malay

Supported by

University of Malaya

IMPACT OF GLOMERULAR FILTARATION RATE (GFR) ON OUTCOMES OF ISOLATED CABG SURGERY

Author

Billah Baki

Institution

Monash University

Abstract

Objectives: It is well known that patients with severe kidney dysfunction (KD) are on high risk for operative mortality and complications following coronary artery bypass graft (CABG) surgery. However, the impact of KD on operative mortality and postoperative outcomes have not been studied for the Australian Cohort. The objective of this study was to compare outcomes of isolated CABG patients with a range from normal kidney function to dialysis dependence.

Methods: Data were collected between 2001 and 2010 from Australia. Mutivariable logistic regression was used to evaluate the association of GFE with operative mortality and postoperative complications (e.g., stroke, balloon pump, new renal failure, return to theatre and ventilation more than 24 hours). The relationship was adjusted for other risk factors.

Results: Of 35202 CABG patients 21133 underwent isolated CABG. Preoperative kidney dysfunction was common among CABG patients: 3.8% had severe GFR (GFR < 30 mL/min/1.73m2), 23.1% had moderate GFR (GFR 30-59 mL/min/1.73m2), 37.6% had mild GFR (GFR 60-89 mL/min/1.73m2) and 1.4% had dialysis. The operative mortality increases as the severity of GFR increases: 0.7% for normal GFR (GFR = 90 mL/min/1.732), 1.4% for mild GFR, 3.0% for moderate GFR, 4.7% for severe GFR and 5.5% for dialysis dependence. Preoperative GFR was appeared as one of the most powerful drivers for 30-day mortality and postoperative complications.

Conclusion: Preoperative GFR was found common in the isolated CABG patients in Australia and is an important predictor for operative mortality and postoperative complications. Patient’s preoperative GFR should be considered into clinical risk assessment and prediction models.