10.6084/m9.figshare.4602112.v1
Shen W.
Shen
W.
Aguilar R.
Aguilar
R.
Montero A.R.
Montero
A.R.
Fernandez S.J.
Fernandez
S.J.
Taylor A.J.
Taylor
A.J.
Wilcox C.S.
Wilcox
C.S.
Lipkowitz M.S.
Lipkowitz
M.S.
Umans J.G.
Umans
J.G.
PowerPoint Slides for: Acute Kidney Injury and In-Hospital Mortality after Coronary Artery Bypass Graft versus Percutaneous Coronary Intervention: A Nationwide Study
Karger Publishers
2017
Acute kidney injury
Renal replacement therapy
In-hospital mortality
Coronary artery bypass graft
Percutaneous coronary intervention
2017-02-01 12:34:22
Presentation
https://karger.figshare.com/articles/presentation/PowerPoint_Slides_for_Acute_Kidney_Injury_and_In-Hospital_Mortality_after_Coronary_Artery_Bypass_Graft_versus_Percutaneous_Coronary_Intervention_A_Nationwide_Study/4602112
<p><b><i>Background:</i></b> Post-procedural acute kidney injury (AKI)
is associated with significantly increased short- and long-term
mortalities, and renal loss. Few studies have compared the incidence of
post-procedural AKI and in-hospital mortality between 2 major modalities
of revascularization - coronary artery bypass grafting (CABG) and
percutaneous coronary intervention (PCI) - and results have been
inconsistent. <b><i>Methods:</i></b> We generated a propensity
score-matched cohort that includes a total of 286,670 hospitalizations
with multi-vessel coronary disease undergoing CABG or PCI (2004-2012)
from the National Inpatient Sample database. We compared incidence of
AKI, AKI requiring renal replacement therapy (RRT), in-hospital
mortality, hospital stay, and charges between CABG and PCI groups. <b><i>Results:</i></b> The incidence of AKI after CABG was higher than PCI (8.9 vs. 4.5%, OR 2.05, 95% CI 1.99-2.12, <i>p</i> < 0.001). The incidence of AKI requiring RRT was also higher after CABG (1.1 vs. 0.5%, OR 2.14, 95% CI 1.96-2.34, <i>p</i> < 0.001). Likewise, in-hospital mortality was higher after CABG than PCI (2.0 vs. 1.4%, OR 1.44, 95% CI 1.35-1.52, <i>p</i>
< 0.001). Among patients with pre-existing chronic kidney disease
(stages I-IV), those undergoing CABG was associated with 2.0-2.3-fold
higher odds of developing AKI than those undergoing PCI. The patients
treated with CABG had a significantly longer hospital stay and higher
hospital charges. <b><i>Conclusions:</i></b> Patients undergoing CABG
are associated with (1) increased risk of developing post-procedural
AKI, (2) higher likelihood of receiving RRT, and (3) worse short-term
survival. Long-term renal outcome remains to be studied.</p>