Outcome in a post-cardiac surgery population with XXXX requiring dialysis: does age make a difference?

@entity1 @entity697 @entity177 @entity810 @entity551 @entity72433
BACKGROUND: @entity810 ( @entity810 ), requiring dialysis ( @entity810 -d), develops in 1-5% of @entity1 undergoing cardiac surgery and is associated with higher in-hospital mortality. Age is one of the known risk factors for the development of @entity810 . As the ageing population is increasing, the nephrologist will be faced with a large population of elderly @entity1 requiring dialysis following cardiac surgery. The aim of our study was to evaluate the influence of age on and the risk factors for in-hospital mortality. METHODS: Eighty-two @entity1 with @entity810 following cardiac surgery and requiring dialysis between January 1997 and October 2001 were included. Two groups of @entity1 were studied: the younger population (<70 years, 42 @entity1 , mean age 59+/-10) and an elderly population (>/=70 years, 40 @entity1 , mean age 76+/-4). Severity of disease was evaluated using the @entity697 ( @entity697 ), the Liano score and the SHARF (Stuivenberg Hospital Acute @entity177 ) score. RESULTS: Overall mortality in the population with @entity810 -d was 56.1%. No difference in mortality rate was found between the younger (61.9%) and elderly @entity1 group (50.0%). The two groups were very similar in baseline and procedural characteristics with exception of body weight (P=0.02) and preoperative glomerular filtration rate (P=0.0001). No significant difference was found in the scoring systems between the old and the young ( @entity697 P=0.52; Liano P=0.96; SHARF T0 P=0.06; SHARF @entity72433 =0.15). Mortality in the elderly was significantly correlated with @entity551 before starting renal replacement therapy (RRT) (P=0.002), mechanical ventilation (P=0.002), presence of @entity177 ( @entity177 ) (P=0.0001) and higher scores in the severity models ( @entity697 : P=0.01; Liano: P<0.0001 and SHARF: P<0.0001). CONCLUSION: The outcome in the elderly requiring dialysis due to @entity810 post-cardiac surgery is comparable with the outcome in a younger population. No significant difference was found in severity of disease between the elderly and the younger. Variables predicting mortality in the elderly are the presence of @entity177 , mechanical ventilation and @entity551 24 h before starting RRT. These findings indicate that at the time the nephrologist is called for an elderly @entity1 requiring dialysis due to @entity810 following cardiac surgery, age per se is not a reason to withhold RRT.
