بررسي ريسك فاكتورهاي مرتبط با عوارض نورولوژيك بعد از اعمال جراحي قلب باز

EVALUATION OF RISK FACTORS FOR ADVERSE NEUROLOGIC OUTCOME AFTER CARDIAC SURGERY

Background & Aims: Neurologic complications following cardiac surgery result in increased morbidity and mortality. Although the incidence of overt squeal has traditionally been higher in patients undergoing isolated intracardiac procedures, recent studies show that the incidence of stroke for coronary artery bypass grafting (CABG), in the range of 1 to 4%. Postoperative cognitive deficits also are a source of morbidity and occur frequently even in low-risk patients undergoing cardiac surgery. Certain predictors have been validated in multiple studies but have not been validated in multiple populations. Materials & Methods: In a retrospective descriptive cross-sectional study we evaluated documents of patients who had neurologic complication after open heart surgery. Demographic data, the history of previous hypertension, diabetes mellitus, stroke, perioperative conditions such as pump time, serum cratinine, blood sugar, and hematocrit were recorded. All the data were collected in patients with neurologic complications that were confirmed by consult. Results: Approximately 514 patients had open heart operation during May 2005-2007. Twenty one patients (4.08%) had neurologic problems during intensive care unit staying. Cerebrovascular accident occurred in 9 (1.7%) and cognitive disorders in 12 (2.33%) of patients. Five (23.8%) patients had history of diabetes mellitus, and nine (42.8%) patients had history of hypertension. Conclusion: Neurologic complications can occur in low risk patients after cardiac anesthesia. Some predictors were postulated but the reliability of these criteria is not clear. Further research about techniques of preventing or mitigating cerebral injury or predictors particularly in high-risk patients is needed.