Mild and moderate renal dysfunction: impact on short-term outcome

Background: Preoperative renal dysfunction is an important risk factor in cardiac surgery. Thus, the association between creatinine clearance (ClCr) and mechanical ventilation time and ICU length of stay, independent of other established preoperative risk indicators, was analyzed. Methods: In our study, 156 consecutive patients underwent open-heart surgery at the Department of Cardiac Surgery, University Hospital St. Andrea, Rome, and were prospectively studied for the relation between the ClCr, using the formula develop by Cockroft and Gault, and ICU length of stay and mechanical ventilation time. The 156 patients were divided into two groups in relation of ClCr: group A (n = 78) ClCr < 70 ml/min; group B (n = 78) ClCr > 70 ml/min. Results: In multivariate analysis, ICU length of stay was influenced by ClCr < 70 ml/min, hypertension and COPD. ICU stay was median 48 h (range 24-72) in group A versus 24 h (range 20.7-44) in group B (p = 0.0001). In multivariate analysis, only ClCr < 70 ml/min and EuroScore were associated with increasing VAM. VAM was median 8 h (range 5.7-13.2) in group A versus 6 h (range 4-10) in group B (p = 0.001). Conclusions: Our study demonstrates that after short-term outcome follow-up, preoperative mild renal dysfunction is an independent predictor of ICU length of stay and mechanical ventilation time. © 2007 European Association for Cardio-Thoracic Surgery.