title: Effect of neurology consults on outcomes for patients suffering transient ischemic attacks after coronary artery bypass grafting.
abstract: Stroke patients appear to have lower morbidity and mortality rates and better outcomes when neurologists serve as the primary admitting physician. The effect of neurological consultations on coronary artery bypass graft (CABG) patients who have suffered a postoperative transient ischemic attack (TIA) has not yet been determined. The authors evaluated whether neurology consultations improved outcomes. A retrospective analysis was conducted of CABG patients from a high-volume tertiary care center. Primary end points included 30-day mortality, discharge disposition, length of stay, and 1-year incidence of stroke. Post-CABG TIA patients receiving a neurological consult (N = 127) were compared with propensity-matched controls. Thirty-day mortality was identical (3.1%), with nonsignificant difference in long-term incidence of stroke. There were no differences in home discharges or length of stay. Including a neurologist in the treating team for patients suffering TIAs after CABG appears not to reduce post-operative incidence of morbidity and mortality, reduce length of stay, or improve patient disposition at discharge.
authors.affiliation: University of California-San Francisco, Fresno, California, USA.
authors.forename: Tanya
authors.initials: T
authors.lastname: Warwick
authors.forename: Maher
authors.initials: M
authors.lastname: Kali
authors.forename: William
authors.initials: W
authors.lastname: Carter
authors.forename: Kristi
authors.initials: K
authors.lastname: Lucas
authors.forename: Shahana
authors.initials: S
authors.lastname: Masood
authors.forename: Rana
authors.initials: R
authors.lastname: Dawli
authors.forename: Mike
authors.initials: M
authors.lastname: Broce
authors.forename: Bernardo
authors.initials: B
authors.lastname: Reyes
mesh_terms: D000368:Aged; D001026:Coronary Artery Bypass; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D002546:Ischemic Attack, Transient / Q000209:etiology*; D007902:Length of Stay; D008297:Male; D009462:Neurology; D011183:Postoperative Complications / Q000209:etiology; D012017:Referral and Consultation; D012189:Retrospective Studies; D012307:Risk Factors