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Published on: March 27, 2018
Early postoperative recovery by chronic dialysis patients after coronary artery bypass grafting
Junko Kobayashi1, Masahiko Ikebuchi, Yasufumi Fujita
1Department of Cardiovascular Surgery, Chikamori Hospital Heart Center, Kochi, Japan.
Insights
Early rehabilitation after coronary artery bypass grafting (CABG) is crucial. Dialysis patients experienced a one-day delay in recovery, primarily due to hemodialysis on postoperative day 1.
Area of Science:
- Cardiovascular Surgery
- Nephrology
- Postoperative Rehabilitation
Background:
- Early rehabilitation post-coronary artery bypass grafting (CABG) reduces complications and costs.
- The impact of early recovery in dialysis patients undergoing CABG requires further investigation.
Purpose of the Study:
- To evaluate and compare the early postoperative recovery of dialysis patients versus non-dialysis patients after isolated CABG.
Main Methods:
- Retrospective study of 348 consecutive elective isolated CABG cases (2001-2006).
- Patients divided into two groups: 18 with dialysis (Group D) and 330 without dialysis (Group N).
- Comparison of recovery milestones: meals, standing, and walking on postoperative days 1 and 2.
Main Results:
- Group D showed significantly delayed recovery in eating, standing, and walking on postoperative day 1 compared to Group N.
- No significant difference in recovery times was observed by postoperative day 2.
- Operative and in-hospital mortalities were 0% in the dialysis group.
Conclusions:
- Dialysis patients undergoing elective isolated CABG experience a one-day delay in early postoperative recovery.
- This delay is primarily attributed to the necessity of hemodialysis on postoperative day 1.
Objective:
A faster start at rehabilitation has been a great benefit in reducing complications and costs after coronary artery bypass grafting (CABG). We studied early postoperative recovery from CABG in dialysis patients.
Methods:
From January 2001 to May 2006, a total of 401 patients underwent isolated CABG at our institution. We retrospectively studied 348 consecutive elective cases, which were divided into two groups; 18 with dialysis (group D) and 330 without dialysis (group N), with respect to having meals, standing, and walking.
Results:
An analysis of patient demographics revealed significant differences in gender, comorbidity of old cerebral infarction, anemia, and water balance during operation (P <0.05). Operative and in-hospital mortalities were 0% in group D. The percentages of the patients who were eating meals, standing, or walking on postoperative day (POD) 1 in group D were 88.9%, 66.6%, and 27.8%, respectively. In group N, these percentages were significantly higher: 96.1%, 85.5%, and 75.8%. But by POD 2, these values became similar. We considered that the delay of rehabilitation in group D was mainly due to hemodialysis on POD 1.
Conclusion:
Early postoperative recovery from elective isolated CABG in dialysis patients delayed a day against nondialysis patients. The delay was considered a result of the inevitable dialysis on POD 1.
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