Document Detail


Neurocognitive outcomes in off-pump versus on-pump bypass surgery: a randomized controlled trial.
MedLine Citation:
PMID:  16731138     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Cognitive difficulties have been reported after coronary artery bypass graft surgery using cardiopulmonary bypass. However, the cognitive benefit of off-pump surgery remains unclear. METHODS: Consecutively listed candidates for elective bypass were randomly assigned to either off-pump or on-pump techniques (n = 107). A battery of 11 standardized neuropsychological tests was administered before surgery, and again at 2 and 6 months after surgery. The two groups were compared using a range of statistical procedures, including growth modeling. RESULTS: There were no significant differences in cognitive test scores between the off-pump and on-pump groups using t tests at any of the time points. There were no differences between off-pump and on-pump groups in the incidence of cognitive deficits at 2 months or 6 months, with the exception that fewer off-pump patients showed impairment on one test of verbal fluency at 6 months. When the pattern of cognitive change over time between the two groups was compared using sophisticated modeling techniques, the two groups were again comparable, except for results on the test of verbal fluency, in which the off-pump group showed more rapid postsurgical cognitive gains than the on-pump group. CONCLUSIONS: The off-pump group appears to be generally comparable to the on-pump group in terms of short-term and long-term postsurgical neurocognitive outcomes.
Authors:
Christine S Ernest; Marian U C Worcester; James Tatoulis; Peter C Elliott; Barbara M Murphy; Rosemary O Higgins; Michael R Le Grande; Alan J Goble
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  81     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2006 Jun 
Date Detail:
Created Date:  2006-05-29     Completed Date:  2007-09-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  2105-14     Citation Subset:  AIM; IM    
Affiliation:
Heart Research Centre, Melbourne, Australia. christine.ernest@heartresearchcentre.org
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MeSH Terms
Descriptor/Qualifier:
Aged
Cardiopulmonary Bypass / adverse effects*
Cognition Disorders / epidemiology,  etiology*
Coronary Artery Bypass / statistics & numerical data*
Coronary Artery Bypass, Off-Pump / statistics & numerical data*
Female
Follow-Up Studies
Humans
Incidence
Male
Middle Aged
Models, Theoretical
Neuropsychological Tests
Postoperative Complications / epidemiology,  etiology*
Speech Disorders / epidemiology,  etiology
Surgical Procedures, Elective
Comments/Corrections
Comment In:
Ann Thorac Surg. 2007 Jul;84(1):358; author reply 358-9   [PMID:  17588460 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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