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Risk factors for open heart surgery in hemodialysis patients

Mitsuhiro Yamamura1, Masataka Mitsuno, Hiroe Tanaka

  • 1Department of Cardiovascular Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan. yamachan@hcm-mail.hyo-med.ac.jp

General Thoracic and Cardiovascular Surgery
|May 15, 2009
PubMed

Insights

Concomitant surgery significantly increases mortality risk in hemodialysis patients undergoing open heart procedures. This finding is crucial for improving outcomes in this high-risk surgical population.

Area of Science:

  • Cardiovascular Surgery
  • Nephrology
  • Critical Care Medicine

Background:

  • Open heart surgery in hemodialysis patients carries higher mortality rates than in non-hemodialysis patients.
  • Identifying specific risk factors is crucial for improving surgical outcomes in this vulnerable population.

Purpose of the Study:

  • To identify significant risk factors associated with mortality following open heart surgery in patients requiring hemodialysis.

Main Methods:

  • A retrospective analysis of 76 hemodialysis patients undergoing open heart surgery between 1990 and 2008.
  • Operations included coronary artery bypass grafting (CABG), aortic valve replacement (AVR), and concomitant AVR plus CABG.
  • Multivariate logistic regression was used to determine independent risk factors for mortality.

Main Results:

  • The in-hospital mortality rate was 17.1%, with a 5-year survival rate of 39%.
  • Univariate analysis identified age (>70), low-output syndrome, and concomitant surgery as risk factors.
  • Multivariate analysis revealed concomitant surgery as the sole significant independent risk factor (OR 4.37, P = 0.007).

Conclusions:

  • Concomitant surgery is a significant independent risk factor for mortality in hemodialysis patients undergoing open heart surgery.
  • These findings highlight the need for careful patient selection and surgical planning for combined procedures in this population.
Abstract

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