PURPOSE: Purpose: Aim of this retrospective observational study has been to assess the rate, in cardiac operated pts, of Acute Postoperative Renal Failure (APRF) (increase of .5 mg/dl of postop. serum creatinine), morbidity and mortality.
METHODS: Methods: From January to December 2005, 1498 pts (mean age 66 ± 12 yrs range 15-92) were admitted to ICU after cardiac surgery. In the postoperative period (PO) 572 pts (mean age 69 ± 10 yrs) (38 %) pts suffered APRF (mean PO creat. 2,2 mg/dl ± 1,3 vs mean preop. creat.(PC) 1,5 mg/dl ± 1 ). We stratified pts into two groups: 298 (52%) with PC > 1,2 mg/dl (mean 2 ± 1,33) (mean age 70.59 ± 9,92 yrs)(group A) and 264 (46.15 %) (mean age 68,42 ± 10,4 yrs) with PC ≤1.2 mg/dl (mean 1 ± 0,189) (group B). We considered the pts who required continous veno-venous haemofiltration (CVVH) and suffered for LOS prone to death.
RESULTS: Results: Global mortality has been 3.8% (57 pts), 50 pts (87.7%) of these suffered for APRF. There isn’t differences for age and type of interventions of the two groups.Group A: 36 pts (12 %)(mean age 70. 67 ± 9.5 yrs) required CVVH, 18 died (50% of the CVVH pts), 17 (94.4 %) suffering for LOS too.Group B: 10 pts (3.78 %) (mean age 68.8 ± 8.7 yrs) needed CVVH, 8 died (80% of the CVVH pts), 6 (75%) suffered LOS too.Group A had 3.4 relative risk (RR) of developing APRF, group B undergoing CVVH show a RR for mortality of 4 if compared with Group A CVVH treated .Group A and B showed 66% and 60% of LOS.
CONCLUSION: Conclusion APRF is a complication in cardiac surgery with increased morbidity and mortality. Preoperative RF is a major preoperative risk factor for renal impairment and mortality. In pts without preop. RF the need of CVVH seems to be lifethreatening.
CLINICAL IMPLICATIONS: Clinical Implication. LOS is strongly associated to postoperative RF and mortality.
DISCLOSURE: Andrea Ballotta, None.