1.Early outcome of cardiac surgery in dialysis-dependent end-stage renal failure patients
Kee Soon Chong ; Cheong Ping Pau ; Muhammad Ibrahim Azmi ; Mohamed Ezani Md Taib ; Jeffrey Jeswant Dillon
The Medical Journal of Malaysia 2020;75(1):43-46
Introduction: Preoperative dialysis-dependent renal failure
is a strong independent risk factor for in-hospital mortality
and morbidity after open heart surgery. This retrospective
study analyses the early outcome in dialysis-dependent
renal failure patients who underwent elective open-heart
surgery in the Institut Jantung Negara (IJN).
Methods: We retrospectively analyse a series of 228
consecutive postoperative patients with dialysis-dependent
(end stage renal failure (ESRF)) admitted to the adult
cardiothoracic ICU in IJN between January 2012 and
December 2016.
Results: The overall early mortality rate included 34 patients
(15.8%). Patients with ESRF underwent combined procedure
recorded a very high mortality rate at 56.3%. Twenty-four
patients (11.2%) needed resternotomy for postoperative
bleeding or cardiac temponade. Postoperative mediastinitis
rate was high, involving 13 patients (6%). The neurological
and gastrointestinal complications rate were recorded at
2.3% (5 patients) and 6% (13 patients) respectively. In the
group of patients (n=199) with sinus rhythm during the
preoperative period, 100 patients (50.3%) developed
postoperative AF. 77 patients (35.8%) stayed in hospital for
more than 14 days.
Conclusions: dialysis-dependent patients undergoing
cardiac surgery poses higher perioperative risk of mortality
and morbidity of 3-4 times higher compared to those
patients with normal renal function. IJN shows acceptable
perioperative risk of mortality and morbidity which is
comparable to other centres