Mildly reduced preoperative ejection fraction increases the risk of stroke in older adults undergoing coronary artery bypass grafting.

Autor: Reyes B; Center for Health Services and Outcomes Research, Charleston Area Medical Center Health Education and Research Institute, West Virginia, USA., Trotter C, Richards M, Ladd J, Broce M, Kali M, Groves S, Lilly D
Jazyk: angličtina
Zdroj: The West Virginia medical journal [W V Med J] 2012 Sep-Oct; Vol. 108 (5), pp. 28, 30-4.
Abstrakt: Introduction: Current guidelines based on clinical trials may have inadvertently excluded a representative cohort of older adults. As a result, little is known about the predictors of stroke among elderly patients undergoing coronary artery bypass surgery (CABG). The purpose of this study was to determine how a lower than normal ejection fraction (EF) predicted post surgery stroke among elderly patients undergoing CABG when compared with younger populations.
Methods: Retrospective cross-sectional cohort analysis. setting: Charleston Area Medical Center, a tertiary medical center.
Participants: 8661 consecutive CABG cases between 2003 and 2009. measurements: PARTICIPANTS were divided into three different age groups: < 65 years old (Group 1), between 65 and 79 years old (Group 2), and > or = 80 years old (Group 3). We calculated the rate of overall neurological complications after CABG for patients with ejection fraction values: < 40%, between 40% and 59%, and > or = 60.
Result: Group 3 (age > = 80) with EF < = 39 had the highest odds of developing post CABG stroke (Odds Ratio (OR): 5.6) followed by Group 3 (age > = 80) with EF 40-59 (OR: 3.9). In addition, Group 2 (age 65-79) with EF < = 39 had the next highest odds of developing post CABG stroke (OR: 2.3) followed by Group 2 (age 65-79) with EF 40-59 (OR: 1.9).
Conclusion: Contrary to current guidelines, in our study population, mildly affected EF increased the overall risk of neurological complications among elderly patients undergoing CABG.
Databáze: MEDLINE
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