Early and Late Outcomes of Thoracic Aortic Surgery in Hemodialysis Patients

Makoto Hibino, Hideki Oshima, Yuji Narita, Tomonobu Abe, Masato Mutsuga, Kazuro L. Fujimoto, Yoshiyuki Tokuda, Sachie Terazawa, Hideki Ito, Akihiko Usui

研究成果: Article査読

7 被引用数 (Scopus)

抄録

Background The number of cardiovascular surgeries among hemodialysis patients is increasing according to the growing population of hemodialysis patients; however, the clinical outcome has not yet been clarified, especially in thoracic aortic surgery. The purpose of this study was to assess the early and late outcomes of thoracic aortic surgery in hemodialysis patients. Methods We retrospectively analyzed the outcomes of 700 consecutive open thoracic aortic surgeries from 2002 to 2014. We identified 21 patients receiving preoperative hemodialysis (group HD) and 679 patients not receiving preoperative hemodialysis (group N). The patients were predominantly male, had diabetes mellitus and cardiogenic shock, and had less hyperlipidemia and elective surgery in group HD. The early and late outcomes were compared between 21 patients in each group using a propensity-score matched analysis. Results The hospital stay and intensive care unit stay were significantly longer in group HD even after matching. The 30-day mortality and inhospital mortality showed no significant differences, whereas the rate of postoperative pneumonia was significantly higher in group HD compared with the matched group N (p = 0.0067). The 1-year, 3-year, and 7-year survival rates in group HD were 73.4%, 45.7%, and 30.5%, respectively, which were significantly poorer than that of group N both in the prematched (p < 0.001) and matched analyses (p = 0.0027). Conclusions Considering the various operative risks associated with hemodialysis patients, the early mortality rate is acceptable, even after the association with many respiratory complications. Although hemodialysis patients have a compromised prognosis after surgery, excessive hesitation to perform thoracic aortic surgery may be avoided.

本文言語English
ページ(範囲)1282-1288
ページ数7
ジャーナルAnnals of Thoracic Surgery
102
4
DOI
出版ステータスPublished - 01-10-2016
外部発表はい

All Science Journal Classification (ASJC) codes

  • 外科
  • 呼吸器内科
  • 循環器および心血管医学

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