Predictors of neurological morbidity after coronary artery bypass surgery

Objective: The aim of this study was to analyze the postoperative neurologi cal complications after myocardial rovascularization. Methods: We analyzed the pre-, peri- and postoperative data of 3834 patients who underwent a pri mary isolated bypass grafting between January 1987 and December 1995. Posto perative neurological complications (A) were divided into mild complication s (B) and major complications (C). Results: The incidence of A increased, f rom 1.4% to 3.0%. Unifactor risk analysis identified: age > 75 years, perip heral vascular atherosclerosis, neurological pathology, aorta-pathology and perioperative myocardial infarction as risk factors for A. Perioperative m yocardial infarction and neurological pathology for B; age > 75 years, peri pheral vascular atherosclerosis, neurological pathology, perioperative myoc ardial infarction and aorta pathology for C. Multifactor risk regression an alysis identified peripheral vascular atherosclerosis. neurological patholo gy, aorta-pathology, perioperative myocardial infarction and the time cohor t 1993-1995 as independent predictors for A; perioperative myocardial infar ction and the time cohort 1993-1995 for B; neurological pathology, aorta-pa thology and perioperative myocardial infarction for C. Conclusions: Periphe ral vascular atherosclerosis, neurological pathology, aorta-pathology, the occurrence of a perioperative myocardial infarction and the time cohort 199 3-1995 are identified as independent risk factors for neurological complica tions. (C) 1999 Elsevier Science B.V. All rights reserved.