| Preoperative cerebral ischemic lesions predict physical health status after on-pump coronary artery bypass surgery. | |
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MedLine Citation:
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PMID: 16308017 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Risk assessment is integral to patient selection and counseling before coronary artery revascularization. We studied the predictive ability of cerebral magnetic resonance imaging of preoperative and postoperative cerebral ischemic injury on self-reported physical and mental health at 3 months after coronary artery bypass surgery with or without use of cardiopulmonary bypass. METHODS: In a prospective clinical trial comparing on-pump and off-pump surgery, 120 patients responded to a questionnaire for self-report of angina (Canadian Cardiovascular Society scale) and physical and mental health status (Short Form 36) at baseline before preoperative cerebral magnetic resonance imaging. Preoperative sets of both magnetic resonance imaging and self-assessments were available for 103 (85.8%) patients. These patients were grouped according to classification of preoperative cerebral magnetic resonance imaging findings. Analysis of covariance determined the association of (1) preoperative magnetic resonance imaging status, (2) new postoperative cerebral lesions, and (3) actual use of cardiopulmonary bypass to physical and mental health. RESULTS: At 3 months after surgical intervention, 98 of 103 patients completed follow-up. The analysis revealed an interaction effect of preoperative cerebral ischemic injury and use of cardiopulmonary bypass on physical health (F = 9.07, P = .003) independent of age. No independent effects on health status were found of baseline magnetic resonance imaging or new cerebral lesions at 3 months. CONCLUSIONS: This study strongly suggests that the combination of preoperative cerebral ischemic injury and use of cardiopulmonary bypass can predict postoperative health status at 3 months. Cerebral magnetic resonance imaging might be a more specific indicator than age for preoperative assessment of vulnerability or resilience during rehabilitation after on-pump cardiac surgery. |
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Authors:
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Lars Mathisen; Marit Helen Andersen; Per Kristian Hol; Bjørn Tennøe; Christian Lund; David Russell; Runar Lundblad; Steinar Halvorsen; Astrid Klopstad Wahl; Berit Rokne Hanestad; Erik Fosse |
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Publication Detail:
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Type: Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The Journal of thoracic and cardiovascular surgery Volume: 130 ISSN: 1097-685X ISO Abbreviation: J. Thorac. Cardiovasc. Surg. Publication Date: 2005 Dec |
Date Detail:
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Created Date: 2005-11-25 Completed Date: 2006-03-21 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0376343 Medline TA: J Thorac Cardiovasc Surg Country: United States |
Other Details:
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Languages: eng Pagination: 1691-7 Citation Subset: AIM; IM |
Affiliation:
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University of Oslo, Faculty Division Rikshospitalet/The Interventional Centre, Oslo, Norway. lars.mathisen@medisin.uio.no |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Brain Ischemia / diagnosis* Cardiopulmonary Bypass Coronary Artery Bypass* / adverse effects Female Health Status* Humans Magnetic Resonance Imaging* Male Middle Aged Postoperative Complications / epidemiology Predictive Value of Tests Preoperative Care Prognosis Prospective Studies Risk Factors Time Factors |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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