Adverse cerebral outcomes after coronary bypass surgery
Adverse cerebral outcomes after coronary bypass surgery
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DOI：
10.1056/nejm199612193352501
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发表时间：
1996-12-19
影响因子：
158.5
通讯作者：
Mangano, DT
中科院分区：
文献类型：
--
作者：
Roach, GW;Kanchuger, M;Mangano, DT
背景 择期冠状动脉搭桥手术后脑功能的急性变化是一个棘手的临床问题。我们进行了一项多中心研究，以确定围手术期不良神经系统事件（包括脑损伤）的发生率和预测因素以及与之相关的资源的使用。方法在一项前瞻性研究中，我们评估了来自 24 个美国机构的 2108 名患者的两大类神经系统结果：I 型（局灶性损伤、出院时木僵或昏迷）和 II 型（智力功能恶化、记忆缺陷或癫痫发作）。结果 129 例患者出现不良脑结果患者（6.1%）。共有 3.1% 的人出现 I 型神经系统结局（8 人死于脑损伤，55 人患有非致命性中风，2 人患有短暂性脑缺血发作，1 人昏迷），3.0% 的人患有 II 型结局（55 人智力功能恶化，8 人癫痫发作）。有不良脑部结局的患者院内死亡率较高（有 I 型结局的患者死亡率为 21%，II 型结局患者的死亡率为 10%，无不良脑部结局的患者为 2%；P
Background Acute changes in cerebral function after elective coronary bypass surgery are a difficult clinical problem. We carried out a multicenter study to determine the incidence and predictors of - and the use of resources associated with - perioperative adverse neurologic events, including cerebral injury.Methods In a prospective study, we evaluated 2108 patients from 24 U.S. institutions for two general categories of neurologic outcome: type I (focal injury, or stupor or coma at discharge) and type II (deterioration in intellectual function, memory deficit, or seizures).Results Adverse cerebral outcomes occurred in 129 patients (6.1 percent). A total of 3.1 percent had type I neurologic outcomes (8 died of cerebral injury, 55 had nonfatal strokes, 2 had transient ischemic attacks, and 1 had stupor), and 3.0 percent had type II outcomes (55 had deterioration of intellectual function and 8 had seizures). Patients with adverse cerebral outcomes had higher in-hospital mortality (21 percent of patients with type I outcomes died, vs. 10 percent of those with type II and 2 percent of those with no adverse cerebral outcome; P