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Acute neurologic complications after coronary artery by pass grafting.


 Domingo, Denize S,
 Enconado, Arissa M,
 De Castro, Estanisla,
 Pasol, Esteban A,
 Domingo, Ma Consuelo,
 Ferriols, Jay Anne G,
 Boiser, Joey C,
 Dofeliz, Francisco L,
 Dy, Marc Wrich G,
 Cuanang, Joven R

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Publication Information

Publication Type
The Philippine Journal of Neurology
2002 Dec
Publication Date


INTRODUCTION: Coronary artery bypass grafting (CABG) prolongs survival of patients with severe coronary artery disease. Neurologic deficits remain among the most devastating complications of this procedure occurring in 9.3 percent of patients based on previous study done at our institution from January of 1991 to August 1995
OBJECTIVES: To determine the occurrence rate of acute neurologic complications after CABG performed at our institution from January 1, 1999 to June 30, 2000
To determine the types of acute neurologic complications that develops after CABG
To determine the factors associated with increased risk of developing acute neurologic complications after CABG
SUBJECTS AND METHODS: A total of 295 patients underwent CABG surgery at our institution from January 1, 1999 to June 30, 2000. One hundred thirty patients were included in the study after computer generated random sampling
RESULTS/DISCUSSION: Mean age was 61.2+/-9.8 years with 20 (15 percent) women. Acute neurologic complications after CABG occurred in 8 patients (6.15 percent), and consisted of strokes in 6, seizures in 1 and altered sensorium in 1. On univariate analysis, only a previous history of stroke was associated with occurrence of acute neurologic complication after CABG. (p=0.015). However, on multivariate analysis, a previous history of stroke (p=0.005), use of intra-aortic balloon pump (p=0.0011), and prolonged cardiopulmonary bypass time of more than 120 minutes (p=0.026) were associated with acute neurologic complications after CABG, while advanced age, diabetes mellitus, hypertension, aortic atherosclerosis, smoking, chronic alcohol intake, number of diseased artery, number of coronary artery bypassed, severity of ventricular dysfunction (hypokinesia) and degree of carotid disease were not. Patients who developed acute neurologic complications have longer hospital stays (mean = 22.4, range 13-31 days) compared to those without neurologic complications (mean 14.4, range 4-26 days). There was no death reported secondary to acute neurologic complication on the study sample
LIMITATIONS OF THE STUDY: The limitations of the study are retrospective study,design, and the neurologic findings were assessed not by a single neurologist performing the preoperative and postoperative examination, thus there may be significant variations in clinical practice and diagnosis. Neuropsychological deficits were not.formally assessed preoperatively and post-operatively
CONCLUSION: The prevalence rate of acute neurologic complications after CABG at our institution from January 1, 1999 to June 30, 2000 is 6.15 percent. The most common acute neurologic complication is stroke, followed by altered sensorium and seizure. Risk factors associated with occurrence of acute neurologic complications are history of previous stroke, prolonged cardiopulmonary bypass time and the use of intra-aortic balloon pump. (Author)

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