SHA 010. The early outcome of coronary artery bypass surgery in hemodialysis-dependent chronic renal failure patients

Abstract

Objective: Coronary artery bypass grafting (CABG) in hemodialysis-dependent patients is associated with high mortality and morbidity rates. This retrospective study was undertaken to identify the risk factors for the 30 days mortality for hemodialysisdependent patients. Methods: Subjects included 85 consecutive hemodialysisdependent patients (63 men and 22 women), aged 50–87 years (mean age, 68 years), who underwent CABG. Operative procedures included CABG alone (n= 52) and CABG with valve replacement, repair, or others (n= 33). A series of peri-operative risk factors were subjected to univariate and multivariate analyses to identify the risk factors for the early mortality. Results: The overall 30 days mortality rate was 14.1% (12/85). Univariate analysis showed the following 4 risk factors to be statistically significant predictors of hospital death: a concomitant cardiac procedure, left ventricular ejection fraction <30%, emergency/urgent surgery, and anemia (hemoglobin <10 mg/dl) (p< 0.05 for each predictor). Multivariate logistic regression analysis however confirmed that a concomitant cardiac procedure (v = 15.090, p= 0.013) is the only statistically significant independent risk factors for hospital death. Conclusion: A concomitant cardiac procedure was identified as significant independent risk factors for hospital mortality after CABG in our population for hemodialysis-dependent patients. Therefore, these pre-operative risk factors may help in predicting operative risks and improving clinical outcomes in hemodialysisdependent patients undergoing CABG.