Mortality and cost of acute and chronic kidney disease after cardiac surgery

被引:39
作者
Lysak, Nicholas [1 ]
Bihorac, Azra [2 ]
Hobson, Charles [3 ]
机构
[1] Univ Florida, Dept Surg, Gainesville, FL USA
[2] Univ Florida, Dept Med, Gainesville, FL USA
[3] Univ Florida, Dept Hlth Serv Res, Gainesville, FL USA
基金
美国国家卫生研究院;
关键词
acute kidney injury; cardiac surgery; chronic kidney disease; cost; mortality; LONG-TERM RISK; ARTERY-BYPASS SURGERY; RENAL DYSFUNCTION; CARDIOTHORACIC SURGERY; PROSPECTIVE COHORT; VASCULAR-SURGERY; SERUM CREATININE; MINIMAL CHANGES; INJURY; OUTCOMES;
D O I
10.1097/ACO.0000000000000422
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Purpose of review Acute and chronic kidney diseases (AKI and CKD) have far-reaching implications for surgical patients in regards to postoperative outcomes and hospital cost. We review the recent literature on the effects of AKI and CKD on morbidity, mortality, and resource utilization among cardiac surgery patients. Recent findings Both AKI and CKD increase the risk for short-term and long-term mortalities, morbidity, length of stay, and hospital cost among postoperative patients, with increasing disease stage correlating with worse outcomes. Even the mildest forms of AKI (RIFLE-R) and CKD (proteinuria without an observed reduction in estimated glomerular filtration rate) demonstrate worse clinical outcomes compared with patients with no AKI or CKD. Outcomes are worse even in patients who achieve full renal recovery before hospital discharge. These complications dramatically increase ICU length of stay, hospital length of stay, resource utilization, and both in-hospital and postdischarge costs, as evidenced by lower rates of discharges to home. Summary AKI and CKD remain prevalent, morbid, and costly conditions for cardiac surgery patients. Better risk stratification, early diagnosis, and earlier interventions are needed to prevent the consequences of these diseases.
引用
收藏
页码:113 / 117
页数:5
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