Document Detail


Preoperative cerebral ischemic lesions predict physical health status after on-pump coronary artery bypass surgery.
MedLine Citation:
PMID:  16308017     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
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:
Created Date:  2005-11-25     Completed Date:  2006-03-21     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1691-7     Citation Subset:  AIM; IM    
Affiliation:
University of Oslo, Faculty Division Rikshospitalet/The Interventional Centre, Oslo, Norway. lars.mathisen@medisin.uio.no
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MeSH Terms
Descriptor/Qualifier:
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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