OBJECTIVE: The aim of this study was to evaluate the incidence and to identify possible predictors of major postoperative neurologic dysfunction (defined as stroke) and to evaluate early clinical outcome in a non-selected cohort. METHOD: A total of 1760 consecutive patients who underwent isolated CABG in the San Lucas Hospital -PUCRS, between January 1997 and February 2004, were enrolled. Demographic and laboratory data, informations regarding the procedure and perioperative endpoints were collected prospectively using a standard protocol of data register of the cardiac postoperative unit of our hospital. We considered statistically significant those variables with a p value no greater than 0.05 with a confidence interval of 95%. RESULTS: In this study, 52 (3%) patients presented with major neurologic dysfunction. On the univariable analysis advanced age, higher prevalence of obstructive pulmonary disease, previous cerebrovascular disease, higher mean value of fibrinogen, occurrence of shock or severe hypotension, presence of supraventricular tachycardia (atrial fibrillation or flutter), occurrence of the systemic inflammatory syndrome and prolonged mechanical ventilation were associated with stroke. On the multivariable analysis previous history of cerebrovascular disease and obstructive pulmonary disease presented as independent predictors for the occurrence of major neurologic dysfunction. Prolonged mechanical ventilation was also independently associated with the endpoint. Furthermore, the occurrence of stroke raised significantly the duration of hospital stay and in-hospital mortality. CONCLUSION: Neurological dysfunction is still a significant cause of morbidity after CABG.
Cerebrovascular acccident; Cerebrovascular disorders; Cardiac surgical procedures; Myocardial revascularization
