Kidney Week

Abstract: SA-PO901

Outcome of Open Heart Surgery in ESRD Patients: A Single Center Experience for 16 Years

Session Information

• Dialysis: Cardiovascular, BP, Volume
  October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

• Choi, Ji-Young, School of Medicine, Kyungpook National University, Daegu, Korea (the Republic of)

Ji-Young Choi,

• Jeong, Kye hwa, School of Medicine, Kyungpook National University, Daegu, Korea (the Republic of)

Kye hwa Jeong,

• Lim, Jeong-Hoon, School of Medicine, Kyungpook National University, Daegu, Korea (the Republic of)

Jeong-Hoon Lim,

• Lee, Kyung hee, School of Medicine, Kyungpook National University, Daegu, Korea (the Republic of)

Kyung hee Lee,

• Kim, Min jung, School of Medicine, Kyungpook National University, Daegu, Korea (the Republic of)

Min jung Kim,

• Jung, Hee-Yeon, School of Medicine, Kyungpook National University, Daegu, Korea (the Republic of)

Hee-Yeon Jung,

• Cho, Jang-Hee, School of Medicine, Kyungpook National University, Daegu, Korea (the Republic of)

Jang-Hee Cho,

• Kim, Chan-Duck, School of Medicine, Kyungpook National University, Daegu, Korea (the Republic of)

Chan-Duck Kim,

• Kim, Yong-Lim, School of Medicine, Kyungpook National University, Daegu, Korea (the Republic of)

Yong-Lim Kim,

• Park, Sun-Hee, School of Medicine, Kyungpook National University, Daegu, Korea (the Republic of)

Sun-Hee Park,

Background

Mortality risk for cardiovascular disease is extremely high in ESRD patients. Nevertheless, dialysis patients are often undertreated due to the higher risk of operation or intervention compared to the general population. However, there are few studies comparing postoperative mortality and morbidity between dialysis and non-dialysis patients in Korea.

Methods

A retrospective analysis of 2,432 patients who underwent open heart surgery from 2002 to 2017 was performed to determine the mortality and morbidity after cardiac surgery in dialysis patients. Of total patients, we obtained comorbidities, NYHA classification, laboratory data, surgical method and postoperative outcomes from the two groups; dialysis group consisting of 38 patients with ESRD undergoing maintenance dialysis and control group consisting of 78 age-, sex-, and status of diabetes- matched control with normal kidney function.

Results

Dialysis group showed significantly higher postoperative mortality rate compared to the control group (18.4% versus 2.6%, P= 0.005). Dialysis group presented with more comorbidities, worse functional class of heart failure than control group. Urgent operation was more frequent (68.4% vs 32.1%, P = 0.000) in dialysis group, but there were no differences in the type of procedure between both groups. The postoperative hospitalization and time in ventilator were significantly increased in dialysis group (OR 4.631, P = 0.034; OR 7.617, P= 0.002). However, there were no significant difference in complication rate including rate of pneumonia, sepsis, stroke, wound infection, arrhythmia, bleeding, heart failure, except pulmonary edema and postoperative CRRT.

Conclusion

Dialysis patients showed higher in-hospital mortality rate compared to the control patients. The duration of postoperative hospitalization and time in ventilator were significantly increased in dialysis group. In dialysis patients, various comorbidities as well as dialysis itself may have contributed to the increase in hospital mortality. However, postoperative complications related to surgery were not significantly different between the two groups.