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Volume 335:1857-1864 December 19, 1996 Number 25 Next

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ABSTRACT

Background Acute changes in cerebral function after elective coronary bypass surgery are a difficult clinical problem. We carried out a multicenter study to determine the incidence and predictors of — and the use of resources associated with — perioperative adverse neurologic events, including cerebral injury.

Methods In a prospective study, we evaluated 2108 patients from 24 U.S. institutions for two general categories of neurologic outcome: type I (focal injury, or stupor or coma at discharge) and type II (deterioration in intellectual function, memory deficit, or seizures).

Results Adverse cerebral outcomes occurred in 129 patients (6.1 percent). A total of 3.1 percent had type I neurologic outcomes (8 died of cerebral injury, 55 had nonfatal strokes, 2 had transient ischemic attacks, and 1 had stupor), and 3.0 percent had type II outcomes (55 had deterioration of intellectual function and 8 had seizures). Patients with adverse cerebral outcomes had higher in-hospital mortality (21 percent of patients with type I outcomes died, vs. 10 percent of those with type II and 2 percent of those with no adverse cerebral outcome; P<0.001 for all comparisons), longer hospitalization (25 days with type I outcomes, 21 days with type II, and 10 days with no adverse outcome; P<0.001), and a higher rate of discharge to facilities for intermediate- or long-term care (47 percent, 30 percent, and 8 percent; P<0.001). Predictors of type I outcomes were proximal aortic atherosclerosis, a history of neurologic disease, and older age; predictors of type II outcomes were older age, systolic hypertension on admission, pulmonary disease, and excessive consumption of alcohol.

Conclusions Adverse cerebral outcomes after coronary bypass surgery are relatively common and serious; they are associated with substantial increases in mortality, length of hospitalization, and use of intermediate- or long-term care facilities. New diagnostic and therapeutic strategies must be developed to lessen such injury.

Source Information

From Kaiser Permanente Medical Center, San Francisco (G.W.R.); New York University, N.Y. (M.K., K.M.); Stanford University, Stanford, Calif. (C.M.M.); Duke University, Durham, N.C. (M.N.); Mercy Medical Center, Redding, Calif. (N.N.); Medical College of Virginia, Richmond (R.W.); Veterans Affairs Medical Center, Milwaukee (A.A.); University of Pittsburgh, Pittsburgh (S.H.G.); the Ischemia Research and Education Foundation, San Francisco (C.L.); and the Veterans Affairs Medical Center, San Francisco (G.O., D.T.M.). Other authors were Ahvie Herskowitz, M.D., Vera Katseva, Ph.D., and Rita Sears, R.N., M.S.

Address reprint requests to Dr. Dennis Mangano at the Ischemia Research and Education Foundation, 250 Executive Park Blvd., Suite 3400, San Francisco, CA 94134.

Full Text of this Article

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Adverse Cerebral Outcomes after Coronary Bypass Surgery
Kouchoukos N. T., Barzilai B., Dávila-Román V. G., Hariawala M. D., Goldsborough M. A., Selnes O. A., McKhann G. M., Roach G. W., Mangano D. T.
Extract | Full Text  
N Engl J Med 1997; 336:1605-1607, May 29, 1997. Correspondence

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• Yoshitani, K., Kawaguchi, M., Okuno, T., Kanoda, T., Ohnishi, Y., Kuro, M., Nishizawa, M. (2007). Measurements of Optical Pathlength Using Phase-Resolved Spectroscopy in Patients Undergoing Cardiopulmonary Bypass. Anesth. Analg. 104: 341-346 [Abstract] [Full Text]  
• Yates, R. B., Stafford-Smith, M. (2006). The genetic determinants of renal impairment following cardiac surgery.. SEMIN CARDIOTHORAC VASC ANESTH 10: 314-326 [Abstract]  
• Agrifoglio, M., Barili, F., Porqueddu, M., Kassem, S., Dainese, L., Pompilio, G., Parolari, A., Biglioli, P. (2006). Left Common Carotid Artery as Inflow Site in Coronary Artery Bypass Grafting. Ann. Thorac. Surg. 82: 2298-2300 [Abstract] [Full Text]  
• Bonatti, J., van Boven, W. J., Nagele, G., Shahin, G., Schachner, T., Laufer, G., Bergman, P., van der Linden, J., The AORTIC Study Group (Assessment Of the Risk of, (2006). Do particulate emboli from the ascending aorta in coronary bypass grafting correlate with aortic wall thickness?. ICVTS 5: 716-720 [Abstract] [Full Text]  
• Burgess, D. C., Kilborn, M. J., Keech, A. C. (2006). Interventions for prevention of post-operative atrial fibrillation and its complications after cardiac surgery: a meta-analysis. Eur Heart J 27: 2846-2857 [Abstract] [Full Text]  
• Jessen, M. E. (2006). Pro: Heparin-Coated Circuits Should be Used for Cardiopulmonary Bypass. Anesth. Analg. 103: 1365-1369 [Full Text]  
• Nussmeier, N. A., Cheng, W., Marino, M., Spata, T., Li, S., Daniels, G., Clark, T., Vaughn, W. K. (2006). Temperature During Cardiopulmonary Bypass: The Discrepancies Between Monitored Sites. Anesth. Analg. 103: 1373-1379 [Abstract] [Full Text]  
• Lilly, K. J, Balaguer, J. M, Pirundini, P. A, Smith, M. A, Connelly, G., Campbell, L. J., Philie, P. C, McAdams, M., Riley, W., Dekkers, R., Fitzgerald, D., Cohn, L. H, Rizzo, R. J (2006). Early results of a comprehensive operative and perfusion strategy to attenuate the incidence of adverse neurological outcomes in on-pump coronary artery bypass grafting (CABG) patients. Perfusion 21: 311-317 [Abstract]  
• Steinbrink, J., Fischer, T., Kuppe, H., Hetzer, R., Uludag, K., Obrig, H., Kuebler, W. M. (2006). Relevance of depth resolution for cerebral blood flow monitoring by near-infrared spectroscopic bolus tracking during cardiopulmonary bypass.. J. Thorac. Cardiovasc. Surg. 132: 1172-1178 [Abstract] [Full Text]  
• Yoshitani, K., de Lange, F., Ma, Q., Grocott, H. P., Mackensen, G. B. (2006). Reduction in Air Bubble Size Using Perfluorocarbons During Cardiopulmonary Bypass in the Rat. Anesth. Analg. 103: 1089-1093 [Abstract] [Full Text]  
• Sedrakyan, A., Wu, A. W., Parashar, A., Bass, E. B., Treasure, T. (2006). Off-Pump Surgery Is Associated With Reduced Occurrence of Stroke and Other Morbidity as Compared With Traditional Coronary Artery Bypass Grafting: A Meta-Analysis of Systematically Reviewed Trials * Supplemental Appendix I. Stroke 37: 2759-2769 [Full Text]  
• Szalma, I., Kiss, A., Kardos, L., Horvath, G., Nyitrai, E., Tordai, Z., Csiba, L. (2006). Piracetam prevents cognitive decline in coronary artery bypass: a randomized trial versus placebo.. Ann. Thorac. Surg. 82: 1430-1435 [Abstract] [Full Text]  
• Dupuis, G., Kennedy, E., Lindquist, R., Barton, F. B., Terrin, M. L., Hoogwerf, B. J., Czajkowski, S. M., Herd, J. A., for the Post CABG Biobehavioral Study Investigator, (2006). Coronary artery bypass graft surgery and cognitive performance.. Am J Crit Care 15: 471-478 [Abstract] [Full Text]  
• Gottesman, R. F., Sherman, P. M., Grega, M. A., Yousem, D. M., Borowicz, L. M. Jr, Selnes, O. A., Baumgartner, W. A., McKhann, G. M. (2006). Watershed Strokes After Cardiac Surgery: Diagnosis, Etiology, and Outcome. Stroke 37: 2306-2311 [Abstract] [Full Text]  
• Rosengart, T. K., Sweet, J. J., Finnin, E., Wolfe, P., Cashy, J., Hahn, E., Marymont, J., Sanborn, T. (2006). Stable Cognition After Coronary Artery Bypass Grafting: Comparisons With Percutaneous Intervention and Normal Controls. Ann. Thorac. Surg. 82: 597-607 [Abstract] [Full Text]  
• Mishra, M., Malhotra, R., Karlekar, A., Mishra, Y., Trehan, N. (2006). Propensity Case-Matched Analysis of Off-Pump Versus On-Pump Coronary Artery Bypass Grafting in Patients With Atheromatous Aorta. Ann. Thorac. Surg. 82: 608-614 [Abstract] [Full Text]  
• Shann, K. G., Likosky, D. S., Murkin, J. M., Baker, R. A., Baribeau, Y. R., DeFoe, G. R., Dickinson, T. A., Gardner, T. J., Grocott, H. P., O'Connor, G. T., Rosinski, D. J., Sellke, F. W., Willcox, T. W. (2006). An evidence-based review of the practice of cardiopulmonary bypass in adults: A focus on neurologic injury, glycemic control, hemodilution, and the inflammatory response.. J. Thorac. Cardiovasc. Surg. 132: 283-290.e3 [Full Text]  
• Epstein, A. J. (2006). Do Cardiac Surgery Report Cards Reduce Mortality? Assessing the Evidence. Med Care Res Rev 63: 403-426 [Abstract]