Abstract: PO1288
Outcomes of Cardiac Surgery in ESKD Patients on Hemodialysis (HD) vs. Peritoneal Dialysis (PD)
Session Information
- Peritoneal Dialysis - 2
October 22, 2020 | Location: On-Demand
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 703 Dialysis: Peritoneal Dialysis
Authors
- Bassil, Elias, Cleveland Clinic, Cleveland, Ohio, United States
- Liaqat, Aimen, Cleveland Clinic, Cleveland, Ohio, United States
- Matta, Milad, Cleveland Clinic, Cleveland, Ohio, United States
- Shah, Ronak Jagdeep, Cleveland Clinic, Cleveland, Ohio, United States
- Taliercio, Jonathan J., Cleveland Clinic, Cleveland, Ohio, United States
- Daou, Remy, Universite Saint-Joseph, Beirut, Lebanon
- Arrigain, Susana, Cleveland Clinic, Cleveland, Ohio, United States
- Konig, Victoria, Cleveland Clinic, Cleveland, Ohio, United States
- Schold, Jesse D., Cleveland Clinic, Cleveland, Ohio, United States
- Harb, Serge C., Cleveland Clinic, Cleveland, Ohio, United States
- Wierup, Per, Cleveland Clinic, Cleveland, Ohio, United States
- Nakhoul, Georges, Cleveland Clinic, Cleveland, Ohio, United States
- Mehdi, Ali, Cleveland Clinic, Cleveland, Ohio, United States
Background
Patients with ESKD have worse outcomes following major cardiac surgery compared to those without ESKD. However, the outcomes of cardiac surgery in PD patients vs. HD patients are not well studied.
Methods
Using our EHR-based Cardio-Thoracic Surgery (CTS) registry, we compared the outcomes of 590 patients with ESKD on HD and PD undergoing Coronary Artery Bypass Graft (CABG) and/or valvular cardiac surgery. We compared baseline demographics and comorbidities between patients on PD and HD using Chi-square and t-tests for categorical and continuous variables respectively. We compared Length of Stay (LOS), days in the ICU, number of transfusions, and post surgical complications: (pericardial effusion, gastro-intestinal (GI) bleed, cardiac arrest, and in-hospital death) using Kruskal-Wallis test, Chi-square and Fisher’s exact tests.
Results
Among 590 patients undergoing cardiac surgery, 62 (11%) were on PD, and 528 (89%) were on IHD. PD patients had a lower proportion of heart failure (50% vs. 72%), lower median Cardio-Pulmonary Bypass (CPB) time (106 vs. 122 minutes), and a higher proportion of dyslipidemia (92% vs. 79%) at baseline. HD and PD patients had no significant differences in post-operative length of stay, number of ICU days, and postoperative complications including GI bleed, pericardial effusion, and cardiac arrest (table 1). There was also no difference in mortality between the two groups. Out of 62 PD patients, 15 (24%) were converted to HD.
Conclusion
There were no significant differences in the measured outcomes between patients on HD vs. patients on PD post cardiac surgery and or valvular surgery.
Post-operative outcomes of HD vs. PD
| Factor | N missing | Overall (N=590) | HD (N=528) | PD (N=62) | p-value |
| Intraoperative RBC Units | 2 | 2.0[0.00,3.0] | 2.0[0.00,3.0] | 2.0[1.00,3.0] | 0.84b |
| Post-op Length of Stay | 0 | 11.0[8.0,18.0] | 11.0[8.0,19.0] | 10.0[7.0,17.0] | 0.21b |
| ICU Total hours | 2 | 95.7[52.2,188.8] | 96.1[52.1,194.1] | 93.3[57.6,164.9] | 0.52b |
| Pericardial effusion | 10 | 36(6.2) | 32(6.2) | 4(6.5) | 0.99d |
| Gastrointestinal Event | 0 | 48(8.1) | 42(8.0) | 6(9.7) | 0.64c |
| Cardiac Arrest | 0 | 29(4.9) | 29(5.5) | 0(0.0) | 0.06d |
| In-Hospital Death | 0 | 26(4.4) | 25(4.7) | 1(1.6) | 0.51d |
Statistics presented as Median [P25, P75], or N (column %). p-values: b=Kruskal-Wallis test, c=Pearson's chi-square test, d=Fisher’s exact test.