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Intraoperative physiologic variables and outcome in cardiac surgery: Part II. Neurologic outcome.

Publication ,  Journal Article
van Wermeskerken, GK; Lardenoye, JW; Hill, SE; Grocott, HP; Phillips-Bute, B; Smith, PK; Reves, JG; Newman, MF
Published in: Ann Thorac Surg
April 2000

BACKGROUND: The impact of alterable physiologic variables on neurologic outcome after coronary artery bypass grafting procedures is unknown. The purpose of this study was to determine whether minimum intraoperative hematocrit, maximum glucose concentration, or mean arterial pressure during cardiopulmonary bypass influences risk-adjusted neurologic outcome after coronary artery bypass grafting. METHODS: Outcome data from 2,862 patients undergoing coronary artery bypass grafting were merged with intraoperative physiologic data. A preoperative stroke risk index was calculated for each patient. Variables found significant by univariate logistic regression were tested in a multivariable model to determine association with outcome. RESULTS: The incidence of stroke or coma in the study population was 1.3%. After controlling for stroke risk and bypass time, only an index of low mean arterial pressure during bypass retained a significant inverse association with outcome (p = 0.0304). CONCLUSIONS: This study found no evidence that glucose concentration or minimum hematocrit are associated with major adverse neurologic outcome. The association between lower pressure during bypass and decreased incidence of stroke or coma persisted in all risk groups. This points to mechanisms other than hypoperfusion as the primary cause of neurologic injury associated with cardiac surgery.

Duke Scholars

Published In

Ann Thorac Surg

DOI

ISSN

0003-4975

Publication Date

April 2000

Volume

69

Issue

4

Start / End Page

1077 / 1083

Location

Netherlands

Related Subject Headings

  • Stroke
  • Retrospective Studies
  • Respiratory System
  • Middle Aged
  • Male
  • Ischemic Attack, Transient
  • Intraoperative Period
  • Humans
  • Hospital Mortality
  • Hematocrit
 

Citation

APA
Chicago
ICMJE
MLA
NLM
van Wermeskerken, G. K., Lardenoye, J. W., Hill, S. E., Grocott, H. P., Phillips-Bute, B., Smith, P. K., … Newman, M. F. (2000). Intraoperative physiologic variables and outcome in cardiac surgery: Part II. Neurologic outcome. Ann Thorac Surg, 69(4), 1077–1083. https://doi.org/10.1016/s0003-4975(99)01443-5
Wermeskerken, G. K. van, J. W. Lardenoye, S. E. Hill, H. P. Grocott, B. Phillips-Bute, P. K. Smith, J. G. Reves, and M. F. Newman. “Intraoperative physiologic variables and outcome in cardiac surgery: Part II. Neurologic outcome.Ann Thorac Surg 69, no. 4 (April 2000): 1077–83. https://doi.org/10.1016/s0003-4975(99)01443-5.
van Wermeskerken GK, Lardenoye JW, Hill SE, Grocott HP, Phillips-Bute B, Smith PK, et al. Intraoperative physiologic variables and outcome in cardiac surgery: Part II. Neurologic outcome. Ann Thorac Surg. 2000 Apr;69(4):1077–83.
van Wermeskerken, G. K., et al. “Intraoperative physiologic variables and outcome in cardiac surgery: Part II. Neurologic outcome.Ann Thorac Surg, vol. 69, no. 4, Apr. 2000, pp. 1077–83. Pubmed, doi:10.1016/s0003-4975(99)01443-5.
van Wermeskerken GK, Lardenoye JW, Hill SE, Grocott HP, Phillips-Bute B, Smith PK, Reves JG, Newman MF. Intraoperative physiologic variables and outcome in cardiac surgery: Part II. Neurologic outcome. Ann Thorac Surg. 2000 Apr;69(4):1077–1083.
Journal cover image

Published In

Ann Thorac Surg

DOI

ISSN

0003-4975

Publication Date

April 2000

Volume

69

Issue

4

Start / End Page

1077 / 1083

Location

Netherlands

Related Subject Headings

  • Stroke
  • Retrospective Studies
  • Respiratory System
  • Middle Aged
  • Male
  • Ischemic Attack, Transient
  • Intraoperative Period
  • Humans
  • Hospital Mortality
  • Hematocrit