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P-32 Inconsistent age dependence of calculated baseline serum creatinine in comparison to measured values
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Method. An observational study was carried out during the period January-May 2010 in two rehabilitation hospitals and two large volume cardiac surgery hospitals. One hundred and seventy two non-transfused patients who had an on-pump cardiac surgical operation followed by a rehabilitation programme in one of the two rehabilitation hospitals were the study population. No transfusions were given during the rehabilitation hospital stay. The exercise tolerance was measured with the 6-minutes walk test at the admission and discharge from the rehabilitation hospital. The level of anaemia was measured in the rehabilitation hospital at the admission and discharge. Results. Patients with haemoglobin less than 10 g/dL at the admission in the rehabilitation institute had a significantly (P⫽0.007) worse performance at the 6-minutes walk test than patients with higher values (258 ⫾ 106 vs. 306 ⫾ 101 metres). This functional gap was totally recovered during a normal rehabilitation period. Other independent factors affecting the exercise tolerance were age, gender, and albumin concentration. Haemoglobin and albumin concentrations at the admission were 10.5 ⫾ 1.3 g/dL and 3.9 ⫾ 0.45 g/dL respectively. During the rehabilitation stay, both the haemoglobin and the albumin concentrations significantly (P⬍ 0.001) rose to 11.8 ⫾1.5 g/dL and 4.3 ⫾ 0.52 g/dL respectively at discharge. Conclusions. Postoperative anaemia with haemoglobin levels of 8 to 10 g/dL are well tolerated in non-transfused patients, and induce only a transient impairment of exercise tolerance. P-32 Inconsistent age dependence of calculated baseline serum creatinine in comparison to measured values Thomas Neugebauer, Martin Bernardi, Michael Hiesmayr, Andrea Lassnigg Medical University of Vienna, Vienna, Austria Introduction. Predicting and early detection of acute kidney injury in patients after cardiac surgery by changes in serum creatinine values are of importance. Where baseline creatinine values (BL-SCrea) are not available, different methods for calculation are proposed [1]. We compared commonly used and suggested formulas and measured BL-SCrea values of a large cohort of surgical patients. Method. We analysed 9142 patients (5905 male, 3237 female) after cardiac surgery from 1997 to 2008, excluding patients with BL-SCrea ⬎2 mg.dL-1 (177 mol/L). We compared the measured BL-SCrea values with calculated values of two commonly used formulas for estimating BL-SCrea, the ’Simplified MDRD’ (Modification of Diet in Renal Disease) formula 1: BL-SCrea ⫽ [75 / (186 x age-0.203 x (0.742 if female) x (1.21 if black))]-0.887 and the three variables formula 2: BL-SCrea ⫽ 0.74 - (0.2 if female) ⫹ (0.08 if black) ⫹ 0.003 x age (in years). Results. Simple mathematic analysis of these two formulas leads to the unexpected result that estimated BL-SCrea is decreasing in formula 1 and increasing in formula 2. Comparison to the measured values and linear regression are shown in two graphs: Conclusion. There is not only a remarkable difference between estimated and measured values on BL-SCrea but furthermore different calculation methods lead to oppositional age dependencies of BL-SCrea. Further investigations are reasonable.
REFERENCE 1. Závada J, Hoste E, Cartin-Ciba R, et al. A comparison of three methods to estimate baseline creatinine for RIFLE classification. Nephrol Dial Transplant 2010; 25: 3911-18. P-33 Slightly elevated baseline serum creatinine before cardiac surgery increases long-term mortality in patients after surgery Martin Bernardi, Michael Hiesmayr, Mohamed Mouhieddine, Andrea Lassnigg Medical University of Vienna, Vienna, Austria Introduction. In patients who are older, more obese, with Type 2 diabetes and hypertension, there is increasing interest in the effects of chronic kidney disease on the cardiovascular system [1]. We tried to investigate the cut-off value from baseline creatinine (BL-SCrea) that is associated with increased long-term mortality after cardiac surgery. Method. 9,490 patients (3,322 female), who underwent cardiac surgery from 1997 to 2008 were included. The prospectively collected data were combined with data from the Statistik Austria on every patient’s death. BL-SCrea was the value recorded just before surgery. We determined the relation between BL-SCrea and long-term mortality, when divided in 4 quartiles (Q): Q1 (⬍80 mmol L-1 n⫽2,404), Q2 (ⱖ80 - ⬍96 mmol L-1 n⫽2,392), Q3 (ⱖ96-⬍112 mmol L-1 n⫽2,347), Q4 (ⱖ112 mmol L-1 n⫽2,347). Results. The mean age was 64 yr in male and 69 yr in our female patients. The mean survival was 5.1 ⫾ 3.6 yr in male and 4.8 ⫾ 3.6 yr in women; overall mortality was 23.8%. The mean BL-SCrea was 109 ⫾ 73 mmol L-1. A BL-SCrea over 112 mmol L-1 increases the long-term mortality (univariate HR 2.43) while patients with lower BL-SCrea have nearly the same risk (HR Q1:0.61; HR Q2:0.67; HR Q3:0.85).
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Method. An observational study was carried out during the period January-May 2010 in two rehabilitation hospitals and two large volume cardiac surgery hospitals. One hundred and seventy two non-transfused patients who had an on-pump cardiac surgical operation followed by a rehabilitation programme in one of the two rehabilitation hospitals were the study population. No transfusions were given during the rehabilitation hospital stay. The exercise tolerance was measured with the 6-minutes walk test at the admission and discharge from the rehabilitation hospital. The level of anaemia was measured in the rehabilitation hospital at the admission and discharge. Results. Patients with haemoglobin less than 10 g/dL at the admission in the rehabilitation institute had a significantly (P⫽0.007) worse performance at the 6-minutes walk test than patients with higher values (258 ⫾ 106 vs. 306 ⫾ 101 metres). This functional gap was totally recovered during a normal rehabilitation period. Other independent factors affecting the exercise tolerance were age, gender, and albumin concentration. Haemoglobin and albumin concentrations at the admission were 10.5 ⫾ 1.3 g/dL and 3.9 ⫾ 0.45 g/dL respectively. During the rehabilitation stay, both the haemoglobin and the albumin concentrations significantly (P⬍ 0.001) rose to 11.8 ⫾1.5 g/dL and 4.3 ⫾ 0.52 g/dL respectively at discharge. Conclusions. Postoperative anaemia with haemoglobin levels of 8 to 10 g/dL are well tolerated in non-transfused patients, and induce only a transient impairment of exercise tolerance. P-32 Inconsistent age dependence of calculated baseline serum creatinine in comparison to measured values Thomas Neugebauer, Martin Bernardi, Michael Hiesmayr, Andrea Lassnigg Medical University of Vienna, Vienna, Austria Introduction. Predicting and early detection of acute kidney injury in patients after cardiac surgery by changes in serum creatinine values are of importance. Where baseline creatinine values (BL-SCrea) are not available, different methods for calculation are proposed [1]. We compared commonly used and suggested formulas and measured BL-SCrea values of a large cohort of surgical patients. Method. We analysed 9142 patients (5905 male, 3237 female) after cardiac surgery from 1997 to 2008, excluding patients with BL-SCrea ⬎2 mg.dL-1 (177 mol/L). We compared the measured BL-SCrea values with calculated values of two commonly used formulas for estimating BL-SCrea, the ’Simplified MDRD’ (Modification of Diet in Renal Disease) formula 1: BL-SCrea ⫽ [75 / (186 x age-0.203 x (0.742 if female) x (1.21 if black))]-0.887 and the three variables formula 2: BL-SCrea ⫽ 0.74 - (0.2 if female) ⫹ (0.08 if black) ⫹ 0.003 x age (in years). Results. Simple mathematic analysis of these two formulas leads to the unexpected result that estimated BL-SCrea is decreasing in formula 1 and increasing in formula 2. Comparison to the measured values and linear regression are shown in two graphs: Conclusion. There is not only a remarkable difference between estimated and measured values on BL-SCrea but furthermore different calculation methods lead to oppositional age dependencies of BL-SCrea. Further investigations are reasonable.
REFERENCE 1. Závada J, Hoste E, Cartin-Ciba R, et al. A comparison of three methods to estimate baseline creatinine for RIFLE classification. Nephrol Dial Transplant 2010; 25: 3911-18. P-33 Slightly elevated baseline serum creatinine before cardiac surgery increases long-term mortality in patients after surgery Martin Bernardi, Michael Hiesmayr, Mohamed Mouhieddine, Andrea Lassnigg Medical University of Vienna, Vienna, Austria Introduction. In patients who are older, more obese, with Type 2 diabetes and hypertension, there is increasing interest in the effects of chronic kidney disease on the cardiovascular system [1]. We tried to investigate the cut-off value from baseline creatinine (BL-SCrea) that is associated with increased long-term mortality after cardiac surgery. Method. 9,490 patients (3,322 female), who underwent cardiac surgery from 1997 to 2008 were included. The prospectively collected data were combined with data from the Statistik Austria on every patient’s death. BL-SCrea was the value recorded just before surgery. We determined the relation between BL-SCrea and long-term mortality, when divided in 4 quartiles (Q): Q1 (⬍80 mmol L-1 n⫽2,404), Q2 (ⱖ80 - ⬍96 mmol L-1 n⫽2,392), Q3 (ⱖ96-⬍112 mmol L-1 n⫽2,347), Q4 (ⱖ112 mmol L-1 n⫽2,347). Results. The mean age was 64 yr in male and 69 yr in our female patients. The mean survival was 5.1 ⫾ 3.6 yr in male and 4.8 ⫾ 3.6 yr in women; overall mortality was 23.8%. The mean BL-SCrea was 109 ⫾ 73 mmol L-1. A BL-SCrea over 112 mmol L-1 increases the long-term mortality (univariate HR 2.43) while patients with lower BL-SCrea have nearly the same risk (HR Q1:0.61; HR Q2:0.67; HR Q3:0.85).