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The Impact of Renal Function on Cardiac Surgery- 3-year experience of a referral center
Session:
Painel 11 -Cardiologia Intervenção 1
Speaker:
Hugo Costa
Congress:
CPC 2020
Topic:
H. Interventional Cardiology and Cardiovascular Surgery
Theme:
26. Cardiovascular Surgery
Subtheme:
26.1 Cardiovascular Surgery – Coronary Arteries
Session Type:
Posters
FP Number:
---
Authors:
Hugo Alex Costa; Raquel Menezes Fernandes; Teresa Faria Da Mota; João De Sousa Bispo; Pedro Oliveira De Azevedo; Daniela Carvalho; Nuno Marques; Ilidio Paulos De Jesus
Abstract
<p><strong> Introduction: </strong>Preoperative renal function (eGFR) is an important prognostic factor in patients undergoing cardiac surgery, being part of several international risk scores. The degrees of renal dysfunction may have a different impact on these patients, so it is essential to understand the risk depending on the dysfunction.</p> <p><strong>Objectives: </strong>Analyze the impact of renal dysfunction and its degrees on final outcome (MORT – death by all causes) in patients undergoing cardiac surgery.</p> <p><strong>Methods: </strong>Observational and retrospective study with descriptive and comparative analysis of patients undergoing cardiac surgery, sent from a Cardiology center, between 1 January 2016 and 31 December 2018. Created 4 groups: Group A - Patients with eGFR >85ml/min; Group B - Patients with eGFR [50-85ml/min]; Group C – Patients with eGFR [30-49ml/min]; Group D – Patients with eGFR <30ml/min (eGFR calculated according to MDRD). In the defined groups, MORT were evaluated through clinical records, and compared 1:1. Descriptive analysis on the demographic and clinical characteristics of patients has been carried out. In the comparative analysis, the Chi-Square test was used for categorical variables and the T-Student test for numerical variables, with a significance level of 95%. SPSS 24.0 was used for statistical analysis.</p> <p><strong>Results:</strong> N591 patients were identified, 71.1% male, mean age of 68.6 years, BMI 27.3Kg/m2. MORT in 13.7% of patients. Group A (33.3%) with MORT in 7.1%; Group B (45.3%) with MORT in 10.8%; Group C (14.2%) with MORT in 34.5%; Group D (2%) with MORT at 41.7%. In the comparison of MORT between the different groups (Group A Vs Group B; Group A Vs Group C; Group B Vs Group C; Group A, B and C Vs Group D) statistically significant differences were obtained for the comparison between Group A and C (p=0.00), Group A and D (p=0.00), Group B and C (p=0.00) and Group B and D (p=0.01).</p> <p><strong>Conclusion: </strong>Death by all causes in 13.7% of patients. The presence of MORT increases with the worsening of eGFR. Between subsequent groups (A Vs B and C Vs D) the differences between MORT were not significant. Statistically significant differences in MORT are evidenced between Group B (50-85ml/min) and Group C (30-49ml/min). The results of this analyses suggest that the cutoff with impact on the final outcome of these patients is eGFR 50ml/min.</p>
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