Association between early and three month cognitive outcome after off-pump and on-pump coronary bypass surgery.
| Autor: | van Dijk D; Department of Anaesthesiology, University Medical Centre Utrecht, Utrecht, the Netherlands. ddijk@azu.nl, Moons KG, Keizer AM, Jansen EW, Hijman R, Diephuis JC, Borst C, de Jaegere PP, Grobbee DE, Kalkman CJ |
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| Jazyk: | angličtina |
| Zdroj: | Heart (British Cardiac Society) [Heart] 2004 Apr; Vol. 90 (4), pp. 431-4. |
| DOI: | 10.1136/hrt.2003.010173 |
| Abstrakt: | Objective: To describe the association between cognitive outcome in the first postoperative week and that at three months after both off-pump and on-pump coronary bypass surgery, and to make a direct comparison of early cognitive outcome after off-pump versus on-pump surgery. Design: Randomised trial with an additional prediction study within the two randomised groups. Setting: Three centres for heart surgery in the Netherlands. Patients: 281 patients, mean age 61 years. Interventions: Participants were randomly assigned to off-pump or on-pump coronary bypass surgery. Main Outcome Measures: Cognitive outcome, assessed by psychologists who administered neuropsychological tests one day before and four days and three months after surgery. A logistic regression model was used to study the predictive association between early cognitive outcome, together with eight clinical variables, and cognitive outcome after three months. Results: Cognitive outcome in the first week after surgery was determined for 219 patients and was a predictor of cognitive decline after three months. This association was stronger in on-pump patients (odds ratio (OR) 5.24, p < 0.01) than in off-pump patients (OR 1.80, p = 0.23). Early decline was present in 54 patients (49%) after off-pump surgery and 61 patients (57%) after on-pump surgery (OR 0.73, p = 0.25). Conclusions: In patients undergoing first time coronary bypass surgery, early cognitive decline predicts cognitive outcome after three months. Early cognitive decline is not significantly influenced by the use of cardiopulmonary bypass. |
| Databáze: | MEDLINE |
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