Abstract
BACKGROUND: Both acute renal failure (ARF) and female sex are strongly associated with mortality after open-heart surgery. This study analyzes the effect of sex and race on the incidence of ARF after open-heart surgery and its influence on mortality.
METHODS: A total of 24,660 patients underwent open-heart surgery at the Cleveland Clinic Foundation (Cleveland, OH) from 1993 to 2000. The primary outcome was ARF defined as ARF requiring dialysis, 50% or greater decline in glomerular filtration rate (GFR) not requiring dialysis, or 50% or greater decline in GFR relative to baseline or requirement of dialysis. The secondary outcome was all-cause hospital mortality.
RESULTS: The overall frequency of ARF requiring dialysis after open-heart surgery was 1.82%. The frequency was greater in women (2.36%) than men (1.60%; P < 0.0001) and blacks (2.94%) than nonblacks (1.70%; P < 0.0001) by univariate analysis. By multivariate analysis, risk for ARF requiring dialysis in women was 1.61 (confidence interval [CI], 1.27 to 2.05; P < 0.0001), but race was not a risk factor. The overall postoperative mortality rate was 2.2%, and for patients with ARF requiring dialysis, it was 61.2% (women, 68.6% versus men, 56.5%; P = 0.01) with an odds ratio of 49.29, whereas in patients with ARF not requiring dialysis, it was 14.1% (women, 13.3% versus men 14.6%; P = 0.63) with an odds ratio of 7.18.
CONCLUSION: Female sex is an independent risk factor for developing ARF after open-heart surgery. The influence of race on risk for ARF is less clear. Regardless of its definition, ARF is strikingly associated with a high risk for mortality.
Original language | English |
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Pages (from-to) | 742-51 |
Number of pages | 10 |
Journal | American Journal of Kidney Diseases |
Volume | 41 |
Issue number | 4 |
DOIs | |
Publication status | Published - 01 Apr 2003 |
Externally published | Yes |
Keywords
- Acute Kidney Injury/epidemiology
- Adult
- Aged
- Black People
- Cardiac Surgical Procedures/statistics & numerical data
- Comorbidity
- Disease Susceptibility
- Female
- Glomerular Filtration Rate
- Hospital Mortality
- Humans
- Incidence
- Male
- Middle Aged
- Postoperative Complications/epidemiology
- Racial Groups
- Renal Dialysis
- Risk Factors
- Sex Factors
- White People