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Eur J Cardiothorac Surg 1999;15:166-172
© 1999 Elsevier Science NL

Predictors of neurological morbidity after coronary artery bypass surgery

^a Department of Thoracic and Cardiac Surgery 414, University Hospital Nijmegen, Nijmegen, The Netherlands
^b Department of Medical Informatics, Epidemiology and Statistics 152, University of Nijmegen, Nijmegen, The Netherlands

Received 31 August 1998; received in revised form 18 November 1998; accepted 25 November 1998.

^* Corresponding author. Department of Thoracic and Cardiac Surgery 414, University Hospital Nijmegen, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands. Tel: +3-24-361-4744; fax: +31-24-354-0129; e-mail: l.noyez@thchir.azn.nl

Objective: The aim of this study was to analyze the postoperative neurological complications after myocardial revascularization. Methods: We analyzed the pre-, peri- and postoperative data of 3834 patients who underwent a primary isolated bypass grafting between January 1987 and December 1995. Postoperative neurological complications (A) were divided into mild complications (B) and major complications (C). Results: The incidence of A increased, from 1.4% to 3.0%. Unifactor risk analysis identified: age>75 years, peripheral vascular atherosclerosis, neurological pathology, aorta-pathology and perioperative myocardial infarction as risk factors for A. Perioperative myocardial infarction and neurological pathology for B; age>75 years, peripheral vascular atherosclerosis, neurological pathology, perioperative myocardial infarction and aorta pathology for C. Multifactor risk regression analysis identified peripheral vascular atherosclerosis, neurological pathology, aorta-pathology, perioperative myocardial infarction and the time cohort 1993–1995 as independent predictors for A; perioperative myocardial infarction and the time cohort 1993–1995 for B; neurological pathology, aorta-pathology and perioperative myocardial infarction for C. Conclusions: Peripheral vascular atherosclerosis, neurological pathology, aorta-pathology, the occurrence of a perioperative myocardial infarction and the time cohort 1993–1995 are identified as independent risk factors for neurological complications.

Key Words: Myocardial revascularization • Comorbidity • Neurological complications • Multifactor analysis

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