OBJECTIVES: The effect of mild-to-moderate elevation of preoperative serum @entity1011 levels on morbidity and mortality from coronary artery bypass grafting has not been investigated in a large multivariable model incorporating preoperative and intraoperative variables. Our first objective was to ascertain the effect of a mild-to-moderate elevation in the preoperative serum @entity1011 level on the need for mechanical renal support; the duration of special care and total postoperative stay; the occurrence of @entity16 ; and hospital mortality. Our second objective was to ascertain which @entity1 variables contributed to an increase in the serum @entity1011 level in association with coronary artery bypass grafting. METHODS: A total of 1427 @entity1 who had no known pre-existing @entity8 and who were undergoing first-time coronary artery bypass grafting with cardiopulmonary bypass were recruited for the study. @entity1 were divided, on the basis of preoperative serum @entity1011 level, into 3 groups as follows: @entity1011 level of less than 130 micromol. L(-1); @entity1011 level of 130 to 149 micromol. L(-1); and @entity1011 level of 150 micromol. L(-1) or greater. A multivariable stepwise logistic regression analysis was used, and variables significant at the 5% level were included when developing the final multivariable models. RESULTS: Multivariable analysis showed that elevation of the preoperative serum @entity1011 level to 130 micromol. L(-1) or greater increased the likelihood of needing mechanical renal support postoperatively (P <.001), as well as the need for postoperative special care (P <.001) and total hospital stay (P <.001). In-hospital mortality was also significantly elevated as the preoperative @entity1011 level rose to 130 to 149 micromol. L(-1) (P =.045) and to 150 micromol. L(-1) or greater (P <.001). It was further observed that @entity1 with preoperative serum @entity1011 levels of 130 to 149 micromol. L(-1) (P =.02), @entity1 with preoperative serum @entity1011 levels of 150 micromol. L(-1) or greater (P =.001), @entity101 @entity1 (P =.007), @entity1 with angina of New York Heart Association class III or greater (P =.001), @entity1 having a nonelective operation (P =.002), and @entity1 having a prolonged cardiopulmonary bypass time (P =.008) had a significantly greater increase in the serum @entity1011 level as a result of coronary artery bypass grafting. Of particular note was the finding that the method of myocardial protection (cardioplegia or @entity955 ) did not significantly influence in-hospital mortality, need for mechanical renal support, or special care or total postoperative hospital stay. CONCLUSIONS: A mild elevation (130-149 micromol. L(-1)) in the preoperative serum @entity1011 level significantly increases the need for mechanical renal support, the duration of special care and total postoperative stay, and the in-hospital mortality. As the preoperative serum @entity1011 level increases further (> or =150 micromol. L(-1)), this effect is more pronounced. No significant difference in outcome was observed between the use of cardioplegia or @entity955 for myocardial protection.

Coronary artery bypass grafting in non-dialysis-dependent mild-to-moderate XXXX .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'patient'] @entity8 :: ('MESH:D007674', 'Disease') :: ['renal disease'] @entity101 :: ('MESH:D006973', 'Disease') :: ['hypertensive'] @entity16 :: ('MESH:D009422', 'Disease') :: ['infective, respiratory, and neurologic complications'] @entity955 :: ('MESH:D001281', 'Disease') :: ['crossclamp fibrillation'] @entity1011 :: ('MESH:D003404', 'Chemical') :: ['creatinine']
@entity8 :: (MESH:D007674,Disease) :: ['renal dysfunction']
