Læknablaðið - 01.05.2022, Blaðsíða 17

L ÆKNABL AÐIÐ 2022/108 237
R A N N S Ó K N
Greinin barst til blaðsins 27. október 2021,
samþykkt til birtingar 21. mars 2022.
samverkandi þátta en jafnframt hefur skert nýrnastarfsemi sterk
tengsl við almennan hrumleika, sem aftur hefur tengsl við aukna
dánaráhættu.26 Rannsókn okkar bætist við fjölda annarra rann-
sókna á árangri kransæðahjáveituaðgerða á Íslandi og fylgikvilla
í kjölfar þeirra. Niðurstöðurnar munu vonandi stuðla að frekari
rannsóknum á þessum sjúklingahópi og vekja athygli á mikilvægi
nýrnastarfsemi hvað varðar árangur þessara algengu aðgerða.
Heimildir
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Þakkir
Þakkir fær Eygló Guðmundsdóttir, verkefnastjóri á hagdeild
Landspítala, fyrir aðstoð við leit að sjúkraskrám. Rannsóknin var
styrkt af Vísindasjóði Landspítala, Rannsóknarsjóði Háskóla Ís-
lands og Minningarsjóði Helgu Jónsdóttur og Sigurliða Kristjáns-
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E N G L I S H S U M M A R Y
Nanna Sveinsdóttir1
Sunna Rún Heiðarsdóttir1
Árni Steinn Steinþórsson1
Hera Jóhannesdóttir2
Alexandra Aldís Heimisdóttir2
Tómas Þór Kristjánsson2
Þórir Einarsson Long3
Ingibjörg Guðmundsdóttir1,4
Martin Ingi Sigurðsson1,5
Tómas Guðbjartsson1,2
1Faculty of Medicine, University of Iceland,
2Departments of Cardiothoracic Surgery,
3Nephrology, 4Cardiology and 5Anesthesia and
Intensive Care, Landspitali University Hospital.
Correspondence: Tómas Guðbjartsson,
tomasgud@landspitali.is
Key words: Coronary artery bypass grafting (CABG),
reduced kidney function, chronic kidney disease,
short-term, complications, outcome
Impact of renal dysfunction on early outcomes of coronary artery bypass grafting surgery
INTRODUCTION: Impaired renal function as seen in chronic kidney disease (CKD) is a known risk factor
for coronary artery diseases and has been linked to inferior outcome after myocardial revascularization.
Studies on the outcome of coronary bypass grafting (CABG) in CKD-patients are scarce. We aimed to study
this subgroup of patients following CABG in a well defined whole-nation cohort, focusing on short term
complications and 30 day mortality.
MATERIALS AND METHODS: A retrospective study on 2300 consecutive patients that underwent CABG at
Landspítali University Hospital 2001-2020. Patients were divided into four groups according to preoperative
estimated glomerular filtration rate (GFR), and the groups compared. GFR 45–59 mL/mín/1.73m2, GFR
30-44 mL/mín/1.73m2, GFR <30 mL/mín/1.73m2 and controls with normal GFR (≥60 mL/mín/1.73m2).
Clinical information was gathered from medical records and logistic regression used to estimate risk
factors of 30-day mortality.
RESULTS: Altogether 429 (18.7%) patients had impaired kidney function; these patients being more than six
years older, having more cardiac symptoms and a higher mean EuroSCORE II (5.0 vs. 1.9, p<0.001) compared
to controls. Furthermore, their left ventricular ejection fraction was also lower, their median hospital
stay extended by two days and major short-term complications more common, as was 30 day mortality
(24.4% vs. 1.4%, p<0.001). In multivariate analysis advanced age, ejection fraction <30% and GFR <30 mL/
min/1.73m2 were independent predictors of higher 30-day mortality (OR=10.4; 95% CI: 3.98-25.46).
CONCLUSIONS: Patients with impaired renal function are older and more often have severe coronary artery
disease. Early complications and 30-day mortality were much higher in these patients compared to controls
and advanced renal failure and the strongest predictor of 30-day mortality.
doi 10.17992/lbl.2022.05.690