Document Detail


Assesment of CABDEAL score as predictor of neurological dysfunction after on-pump coronary artery bypass grafting surgery.
MedLine Citation:
PMID:  23288185     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
INTRODUCTION: Neurological dysfunction is a feared postoperative morbidity of cardiac surgery, an important cause of death and increased spending in hospitals. Its prediction, however, is still uncertain. OBJECTIVE: To assess the applicability of a preoperative score as a predictor of neurological dysfunction after coronary artery bypass grafting (CABG) under cardiopulmonary bypass (CPB). METHODS: Prospective study that evaluated 77 patients who underwent CABG from February to October 2011. Using the score CABDEAL (creatinine, age, body mass index, diabetes, emergency surgery, abnormality on ECG, lung disease), patients were grouped into high (CABDEAL > 4) and low risk (CABDEAL<4). The predictive value of the score was compared with intraoperative and postoperative variables (aortic clamping time, CPB and ventilation time) as predictors of encephalopathy and stroke. Data were analyzed with descriptive statistics and compared with the Fisher exact test. ROC curve analysis was performed to evaluate the accuracy of the model for the neurological outcomes. It was considered the significant value P<0.05. RESULTS: The mortality rate was 2.6% (n=2). There were 2 episodes of stroke (2.6%) and 12 (15.5%) of encephalopathy. High risk CABDEAL (P=0.0009), ventilation time (P=0.014), CPB time (P=0.02) and aortic clamping time (P=0.006) were significantly associated with encephalopathy. The aortic clamping time was also associated with stroke (P=0.03) and death (P=0.006). CABDEAL score showed the largest area under the ROC curve rather than others variables. CONCLUSION: In this study, the CABDEAL score stood out as the best predictor of encephalopathy after CABG when compared to the others intraoperative variables.
Authors:
Vinícius José da Silva Nina; Maria Iracema de Amorim Rocha; Rayssa Fiterman Rodrigues; Vanessa Carvalho de Oliveira; João Lívio Linhares Teixeira; Eduardo Durans Figueredo; Rachel Vilela de Abreu Haickel Nina; Carlos Antonio Coimbra Sousa
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Publication Detail:
Type:  JOURNAL ARTICLE    
Journal Detail:
Title:  Revista brasileira de cirurgia cardiovascular : orgao oficial da Sociedade Brasileira de Cirurgia Cardiovascular     Volume:  27     ISSN:  1678-9741     ISO Abbreviation:  Rev Bras Cir Cardiovasc     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2013-1-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9104279     Medline TA:  Rev Bras Cir Cardiovasc     Country:  -    
Other Details:
Languages:  ENG; POR     Pagination:  429-435     Citation Subset:  -    
Affiliation:
Serviço de Cirurgia Cardíaca, Hospital Universitário, Universidade Federal do Maranhão, São Luís, MA, Brasil.
Vernacular Title:
Avaliação do escore CABDEAL como preditor de disfunção neurológica no pós-operatório de revascularização miocárdica com circulação extracorpórea.
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