Assesment of CABDEAL score as predictor of neurological dysfunction after on-pump coronary artery bypass grafting surgery

Nina, Vinicius José da Silva; Rocha, Maria Iracema de Amorim; Rodrigues, Rayssa Fiterman; Oliveira, Vanessa Carvalho de; Teixeira, João Lívio Linhares; Figueredo, Eduardo; Nina, Rachel Vilela de Abreu Haickel; Sousa, Carlos Antonio Coimbra

doi:10.5935/1678-9741.20120072

Cited by 2 publications

(8 citation statements)

References 27 publications

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“…38,45 While this study found no effect of creatinine levels on neurological outcome, other studies have supported this assertion. 38 Creatinine levels were found to impact executive function at both 1 month and 1 year. 39 The impact of preoperative anemia in CABG surgery has been debated as well.…”

Section: Perioperative Risk Factors and Strokecontrasting

confidence: 45%

Prediction of stroke reconvalescence after coronary bypass surgery indicated by CT scan parameters

Irqsusi

Schweinsberg

Johnson

et al. 2022

Journal of Cardiac Surgery

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Background: Stroke in the postoperative time course after heart surgery remains a serious risk. Cranial computer tomography (CCT) is the first line option to detect severe intracranial damage. However, only few data are available to predict neurological outcome. Using visual rating scales (VRSs), this study addresses reliability and effectivity to indicate neurological status and likelyhood of improvement.Methods: In a single-center retrospective evaluation, 3719 patients underwent coronary bypass surgery. Because of a delayed recovery phase and neurologic deficits after cardiac surgery 109 patients had a cranial CT scan in the early postoperative period. The incidence of clinically relevant findings within the imaging was rated by an experienced neuroradiologist using two VRS, that is, the age-related white matter changes (ARWMCs) and the Mendes-Ribeiro visual rating scale (MRVRS). Both are computer-assisted measurement schemes to detect stroke-related intracranial damage. Follow-up was investigated with regard to clinical outcome and patient-related risk profiles.Results: Of 109 patients with postoperative cranial CT scans due to prolonged recovery phases or proven neurological damage 44.5% had one cerebral defect in CCT imaging scans only. The others showed multiple defects. During hospital stay, 92.3% experienced neurological improvement exposing reduced ARWMC, while 7.1% had no improvement and correlating high scores. Of both scales, the ARWMC-VRS demonstrated superior accuracy and discrimination. The preoperative ejection fraction (EF), arteriosclerotic degeneration of carotid arteries, and reduced glomerular filtration rate were found to have a high correlation (r = 0.0005) with the latter group. In-hospital mortality of this cohort was 8.18%.

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Section: Perioperative Risk Factors and Strokecontrasting

confidence: 45%

Prediction of stroke reconvalescence after coronary bypass surgery indicated by CT scan parameters

Irqsusi

Schweinsberg

Johnson

et al. 2022

Journal of Cardiac Surgery

View full text Add to dashboard Cite

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“…Whitlock conducted a study [ 14 ] that found age ≥ 65 years to be an independent predictor of risk of stroke, with an OR of 1.9 (95% CI 1.8 - 2.0) [ 14 ] . Age is also a predictive factor of risk of stroke in the majority of risk scores in other studies [ 3 , 6 , 8 , 12 ] .…”

Section: Discussionmentioning

confidence: 95%

“…Many studies have demonstrated that advanced age is an independent risk factor for occurrence of stroke [ 4 , 6 , 15 , 16 ] . It is believed that the increasing age of patients currently treated with heart surgery, which is a consequence of increasing longevity, is associated with more comorbidities and greater susceptibility to cerebrovascular complications [ 3 ] . Carrascal et al [ 4 ] conducted a study with the objective of identifying the influence of age on the incidence of stroke after CABG and found a 4.1% rate of the outcome among octogenarian patients, compared to 3.5 % in other patients.…”

Section: Discussionmentioning

confidence: 99%

“…In constructing this risk score, one point was attributed to CPB time ≥ 110 minutes, with an OR of 1.7 (95% CI 1.2 - 2.5). Many studies have suggested a relationship between CPB time and CVD after surgical procedures [ 1 , 3 , 25 ] . Tarakji et al [ 22 ] conducted a study with 45,432 patients, demonstrating that use of CPB increased the likelihood of the outcome fivefold.…”

Section: Discussionmentioning

confidence: 99%

“…However, despite technological developments and improvements in heart surgery techniques, complications such as cerebral vascular accident (stroke) remain a challenge, causing high rates of morbidity and mortality. Stroke is a heart surgery complication responsible for considerable mortality and morbidity, with estimated incidence rates in the literature from 1.3 to 4.3% and mortality rates in the range of 13 to 41% [ 1 - 3 ] . It extends the duration of intensive care and increases the length of in-hospital stay and the need for home care, raises hospital costs, and has a major impact on the quality of life of survivors [ 1 ] .…”

Section: Introductionmentioning

confidence: 99%

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Risk Score Elaboration for Stroke in Cardiac Surgery

Magedanz¹,

Guaragna²,

Albuquerque³

et al. 2021

Braz J Cardiovasc Surg

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Introduction Stroke is a complication that causes considerable morbidity and mortality during the heart surgery postoperative period (incidence: 1.3 to 5%; mortality: 13 to 41%). Models for assessing the risk of stroke after heart surgery have been proposed, but most of them do not evaluate postoperative morbidity. The aim of this study was to develop a risk score for postoperative stroke in patients who undergo heart surgery with cardiopulmonary bypass. Methods A cohort study was conducted with data from 4,862 patients who underwent surgery from 1996 to 2016. Logistic regression was used to assess relationships between risk factors and stroke. Data from 3,258 patients were used to construct the model. The model’s performance was then validated using data from the remainder of the patients (n=1,604). The model’s accuracy was tested using the area under the receiver operating characteristic (ROC) curve. Results The prevalence of stroke during the postoperative period was 3% (n=149); 59% of the patients who exhibited this outcome were male, 51% were aged ≥ 66 years, and 31.5% of the patients died. The variables that remained as independent predictors of the outcome after multivariate analysis were advanced age, urgent/emergency surgery, peripheral arterial occlusive disease, history of cerebrovascular disease, and cardiopulmonary bypass time ≥ 110 minutes. The area under the ROC curve was 0.71 (95% confidence interval 0.66 - 0.75). Conclusion We were able to develop a risk score for stroke after heart surgery. This score classifies patients as low, medium, high, or very high risk of a surgery-related stroke.

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Assesment of CABDEAL score as predictor of neurological dysfunction after on-pump coronary artery bypass grafting surgery

Cited by 2 publications

References 27 publications

Prediction of stroke reconvalescence after coronary bypass surgery indicated by CT scan parameters

Prediction of stroke reconvalescence after coronary bypass surgery indicated by CT scan parameters

Risk Score Elaboration for Stroke in Cardiac Surgery

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