Increased Short-Term and Mid-Term Major Complications Were Observed in Elderly Patients with Renal Dysfunction after Surgical Ventricular Restoration

Heart Surg Forum. 2018 May 24;21(3):E194-E200. doi: 10.1532/hsf.1911.

Abstract

Background: This study was conducted to explore the impact of renal dysfunction on short-term and mid-term outcomes in elderly patients.

Methods: Patients over 65 years of age receiving surgical ventricular restoration (SVR) were included in the study. They were stratified through estimated glomerular filtration rate (eGFR), with a cutoff point of 60 mL/min/1.73m2. Risk-adjusted analysis, including propensity score matching, was carried out to compare short-term and mid-term outcomes between the two groups of patients.

Results: From January 1999 to December 2015, a total of 280 elderly patients underwent SVR. Of the patients, 79 had eGFR lower than 60 mL/min/1.73m2 and were considered to have renal dysfunction. Mortality was higher in the renal dysfunction group than the normal renal function group, with marginal significance (adjusted P value = .06). The need for mechanical supports (adjusted P value = .04) was higher in the renal dysfunction group. Hemofiltration (adjusted P value < .01) and requirements for transfusion (adjusted P value = .03) were significantly higher in the renal dysfunction group than in the group with normal renal function. The presence of renal dysfunction was associated with higher risk of major adverse cerebro-cardiovascular events (MACCE) than normal renal function (HR = 2.34, 95% CI = 1.34 - 4.08, P = .003).

Conclusion: Compared to patients with normal renal function, elderly SVR patients with renal failure have a higher incidence of short-term mechanical support, mid-term mortality, and MACCE events.

Keywords: urgical ventricular restoration,renal dysfunction,elderly,complications.

MeSH terms

  • Age Factors
  • Aged
  • Cardiac Surgical Procedures / adverse effects*
  • China / epidemiology
  • Echocardiography
  • Female
  • Follow-Up Studies
  • Glomerular Filtration Rate
  • Heart Ventricles / surgery*
  • Humans
  • Incidence
  • Male
  • Myocardial Ischemia / diagnosis
  • Myocardial Ischemia / surgery*
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / etiology
  • Propensity Score
  • Renal Insufficiency / epidemiology*
  • Renal Insufficiency / etiology
  • Retrospective Studies
  • Risk Factors
  • Survival Rate / trends
  • Time Factors