In an article published by The Annals of Thoracic Surgery, physicians found poor kidney function prior to heart surgery can be linked to longer hospital stays and higher surgical costs, according to The Society of Thoracic Surgeons.
Damien J. LaPar, MD, from the University of Virginia in Charlottesville, Va., and colleagues analyzed patient records from a statewide database for 46,577 patients who underwent coronary artery bypass grafting surgery. Preoperative kidney function was determined using creatinine clearance, a blood test that measures how well the kidneys are working, especially how well it is filtering out waste.
Here are six key facts:
1. Kidney failure following heart surgery is one of the main causes of postoperative deaths, with previous research finding mortality rates of up to 50 percent after surgery. Postoperative kidney failure also has been shown to potentially affect short- and long-term patient outcomes.
2. Dr. LaPar,said that while the relationship between poor kidney function and worse outcomes after heart surgery has been well-established, the ability to predict the impact of preoperative renal insufficiency on hospital costs and healthcare resource utilization was unknown.
3. The study was designed to evaluate the relationship between preoperative kidney function, hospital resource utilization and cost of hospitalization after heart surgery.
4. Results showed preoperative kidney function is strongly associated with the cost of performing CABG surgery and can predict increased costs and hospital resource utilization. Specifically, as creatinine clearance decreased from 80 ml per minute to 60 ml per minute, 40 ml per minute and 20 ml per minute predicted total costs increased by 10 percent, 20 percent and 30 percent respectively.
5. Researchers also found worsening kidney function was related to length of hospital stay and lower creatinine clearance led to a longer length of stay. Increasing creatinine clearance was found to reduce the likelihood of needing dialysis after surgery and of operative mortality.
6. Dr. LaPar encourages patients to consider discussing the assessment of their kidney function with their surgeon prior to undergoing surgery to have a better understanding of possible complications.