Background
Methods
Patients
Operative procedure of on-pump beating heart CABG and renal management
Outcomes
Statistical analysis
Results
Demographic characteristics
Characteristic | Before matching | After matching | ||||
---|---|---|---|---|---|---|
Non-dialysis patients | Dialysis patients | P-value | Non-dialysis patients | Dialysis patients | P-value | |
(N = 549) | (N = 110) | (N = 89) | (N = 89) | |||
Age, years | 63.00 (57.00–69.00) | 62.00 (55.00–67.00) | 0.065 | 62.94 ± 9.57 | 62.69 ± 9.08 | 0.854 |
Male sex | 443 (80.69%) | 74 (67.27%) | 0.002 | 63 (70.79%) | 64 (71.91%) | 0.868 |
BMI, kg/m2 | 25.92 (23.46–28.40) | 24.58 (22.03–26.44) | < .001 | 24.28 (21.91–27.34) | 24.80 (22.43–26.40) | 0.671 |
EuroSCOREa | ||||||
Additive | 4.00 (2.00–7.00) | 8.00 (5.50–10.00) | < .001 | 6.00 (3.00–9.00) | 8.00 (5.00–10.00) | 0.005 |
Logistic | 2.59 (1.32–6.21) | 8.91 (4.73–17.60) | < .001 | 4.58 (2.24–11.94) | 7.62 (4.10–15.20) | 0.010 |
Year of surgery | 0.123 | 0.462 | ||||
2009–2010 | 71 (12.93%) | 9 (8.18%) | 13 (14.61%) | 7 (7.87%) | ||
2011–2012 | 121 (22.04%) | 15 (13.64%) | 17 (19.1%) | 12 (13.48%) | ||
2013–2014 | 98 (17.85%) | 24 (21.82%) | 19 (21.35%) | 22 (24.72%) | ||
2015–2016 | 105 (19.13%) | 26 (23.64%) | 15 (16.85%) | 18 (20.22%) | ||
2017–2019 | 154 (28.05%) | 36 (32.73%) | 25 (28.09%) | 30 (33.71%) | ||
Smoking status | < .001 | > 0.999 | ||||
Never-smoker | 354 (64.48%) | 95 (86.36%) | 75 (84.27%) | 75 (84.27%) | ||
Ex-smoker | 71 (12.93%) | 4 (3.64%) | 5 (5.62%) | 4 (4.49%) | ||
Current smoker | 124 (22.59%) | 11 (10.00%) | 9 (10.11%) | 10 (11.24%) | ||
Preoperative EF, % | < .001 | 0.921 | ||||
> 50, normal LV function | 385 (70.13%) | 52 (47.27%) | 48 (53.93%) | 47 (52.81%) | ||
40–50, mild LV dysfunction | 77 (14.03%) | 26 (23.64%) | 18 (20.22%) | 19 (21.35%) | ||
30–40, moderate LV dysfunction | 52 (9.47%) | 21 (19.09%) | 18 (20.22%) | 16 (17.98%) | ||
< 30, severe LV dysfunction | 35 (6.38%) | 11 (10%) | 5 (5.62%) | 7 (7.87%) | ||
Postoperative EF, % | 0.080 | 0.455 | ||||
> 50, normal LV function | 370 (67.4%) | 60 (54.55%) | 48 (53.93%) | 50 (56.18%) | ||
40–50, mild LV dysfunction | 83 (15.12%) | 24 (21.82%) | 17 (19.1%) | 20 (22.47%) | ||
30–40, moderate LV dysfunction | 50 (9.11%) | 13 (11.82%) | 9 (10.11%) | 11 (12.36%) | ||
< 30, severe LV dysfunction | 46 (8.38%) | 13 (11.82%) | 15 (16.85%) | 8 (8.99%) | ||
CCS Angina Class | 0.001 | 0.887 | ||||
I or II | 141 (25.68%) | 19 (17.27%) | 17 (19.1%) | 15 (16.85%) | ||
III | 210 (38.25%) | 30 (27.27%) | 26 (29.21%) | 25 (28.09%) | ||
IV | 198 (36.07%) | 61 (55.45%) | 46 (51.69%) | 49 (55.06%) | ||
Comorbidities | ||||||
Diabetes mellitus | 307 (55.92%) | 78 (70.91%) | 0.004 | 55 (61.8%) | 62 (69.66%) | 0.269 |
Hypertension | 422 (76.87%) | 89 (80.91%) | 0.354 | 68 (76.4%) | 73 (82.02%) | 0.356 |
Hyperlipidemia | 341 (62.11%) | 38 (34.55%) | < .001 | 33 (37.08%) | 34 (38.2%) | 0.877 |
COPD | 19 (3.46%) | 1 (0.91%) | 0.225 | 3 (3.37%) | 1 (1.12%) | 0.621 |
Cardiac dysfunction | 107 (19.49%) | 31 (28.18%) | 0.041 | 27 (30.34%) | 23 (25.84%) | 0.505 |
Renal dysfunction | 17 (3.1%) | 4 (3.64%) | 0.7659 | 7 (7.87%) | 4 (4.49%) | 0.350 |
PAOD | 12 (2.19%) | 14 (12.73%) | < .001 | 6 (6.74%) | 7 (7.87%) | 0.773 |
Liver insufficiency | 23 (4.19%) | 10 (9.09%) | 0.031 | 8 (8.99%) | 6 (6.74%) | 0.578 |
Cerebral deficits | 48 (8.74%) | 20 (18.18%) | 0.003 | 17 (19.1%) | 17 (19.1%) | > 0.999 |
Number of grafts | 0.005 | 0.969 | ||||
1 | 17 (3.1%) | 0 (0%) | - | - | ||
2 | 45 (8.2%) | 11 (10%) | 10 (11.24%) | 9 (10.11%) | ||
3 | 112 (20.4%) | 37 (33.64%) | 26 (29.21%) | 26 (29.21%) | ||
≥ 4 | 375 (68.31%) | 62 (56.36%) | 53 (59.55%) | 54 (60.67%) | ||
Complete revascularization b | 485 (89.48%) | 89 (80.91%) | 0.012 | 73 (82.02%) | 73 (82.02%) | > 0.999 |
Grafting Strategy | < .001 | 0.541 | ||||
NO ITA | 39 (7.1%) | 5 (4.55%) | 6 (6.74%) | 4 (4.49%) | ||
SITA | 352 (64.12%) | 93 (84.55%) | 75 (84.27%) | 73 (82.02%) | ||
BITA | 158 (28.78%) | 12 (10.91%) | 8 (8.99%) | 12 (13.48%) | ||
IABP use | 119 (21.68%) | 25 (22.73%) | 0.808 | 26 (29.21%) | 17 (19.1%) | 0.115 |
Years of follow-up | 3.88 (1.61–7.00) | 2.24 (0.73–4.01) | < .001 | 4.57 (1.15–6.84) | 2.14 (0.73–4.13) | 0.001 |
Variable | Non-dialysis patients | Dialysis patients | P-value |
---|---|---|---|
(N = 89) | (N = 89) | ||
Short-term outcomes | |||
In-hospital mortality | 4 (4.49%) | 8 (8.99%) | 0.232 |
Length of hospital stay for surgery, days | 12 (10–15) | 14 (11–18) | 0.016 |
Surgical complications | |||
Cardiac | 3 (3.37%) | 3 (3.37%) | > 0.999 |
Non-cardiac | 26 (29.21%) | 24 (26.97%) | 0.739 |
Sepsis | 3 (3.37%) | 4 (4.49%) | > 0.999 |
Wound infection | 8 (8.99%) | 4 (4.49%) | 0.232 |
Respiratory failure | 4 (4.49%) | 7 (7.87%) | 0.350 |
Hyperkalemia | 3 (3.37%) | 2 (2.25%) | > 0.999 |
Gastrointestinal bleeding | 1 (1.12%) | 2 (2.25%) | > 0.999 |
Stroke | 3 (3.37%) | 2 (2.25%) | > 0.999 |
Reoperation for hemorrhage control | 5 (5.62%) | 8 (8.99%) | 0.387 |
Requiring ventilation > 24 h | 9 (10.11%) | 7 (7.87%) | 0.600 |
Long-term outcomes | |||
Postoperative outcome | |||
Recurrent angina | 17 (19.1%) | 12 (13.48%) | 0.310 |
Post-CABG MI | 6 (6.74%) | 15 (16.85%) | 0.037 |
Post-CABG reintervention | 16 (17.98%) | 20 (22.47%) | 0.455 |
PCI for failed LAD graft | 6 (6.74%) | 4 (4.49%) | 0.515 |
PCI for non-CABG RCA or LCX | 7 (7.87%) | 10 (11.24%) | 0.444 |
PCI for failed SVG graft | 8 (8.99%) | 14 (15.73%) | 0.172 |
Late mortality a | 8 (9.41%) | 21 (25.93%) | 0.005 |
Characteristic | HD | PD | P-value |
---|---|---|---|
(N = 99) | (N = 11) | ||
In-hospital mortality | 7 (7.07%) | 2 (18.18%) | 0.222 |
Length of stay for surgery, days | 14 (11–19) | 12 (10–15) | 0.081 |
Complications | |||
Cardiac | 2 (2.02%) | 2 (18.18%) | 0.049 |
Non-cardiac | 28 (28.28%) | 3 (27.27%) | > 0.999 |
Sepsis | 5 (5.05%) | 0 (0%) | > 0.999 |
Wound infection | 6 (6.06%) | 0 (0%) | > 0.999 |
Respiratory failure | 7 (7.07%) | 1 (9.09%) | 0.582 |
Hyperkalemia | 2 (2.02%) | 0 (0%) | > 0.999 |
Gastrointestinal bleeding | 2 (2.02%) | 0 (0%) | > 0.999 |
Stroke | 2 (2.02%) | 0 (0%) | > 0.999 |
Reoperation for hemorrhage control | 9 (9.09%) | 1 (9.09%) | > 0.999 |
Requiring ventilation > 24 h | 9 (9.09%) | 1 (9.09%) | > 0.999 |
Major adverse cardiac events | |||
Late mortality | 24 (24.24%) | 2 (18.18%) | > 0.999 |