title: [Neurologic injury after off-pump coronary artery bypass grafting in elder patients with a history of cerebral infarction].
abstract: OBJECTIVE
  To study neurologic injury after off-pump coronary artery bypass grafting (OPCABG) in elder patients with a history of stroke.
  
  
  METHODS
  108 patients (age ≥ 60 years) undergoing elective OPCABG with a history of stroke were studied. Each study patient was matched with 1 control patient who had no stroke history and was undergoing elective OPCABG either immediately before or immediately after the study patients by the same surgeon. Preoperative characteristics, ICU stay, hospital stay, hospital mortality, postoperative neurologic injury were compared in the two groups.
  
  
  RESULTS
  The incidence of neurologic injury after operation among the study group was higher than those in control group (P < 0.01) (27.8% vs 4.6%). The incidence of delirium and stroke after operation among the study group was higher than those in control group (P < 0.05) (20.4% vs 3.7%, 7.4% vs 0.9%); The study group took longer to stay in ICU and hospital than the control group [(26.5 ± 16.4) h vs (21.6 ± 8.8) h, (23.6 ± 9.2) d vs (19.4 ± 5.7) d, P < 0.01]. Logistic regression analysis showed that the risk factors of neurologic injury after OPCABG included previous stroke (OR 6.269, 95%CI 2.218 - 17.717), age (OR 1.131, 95%CI 1.032 - 1.239), hypertension (OR 5.072, 95%CI 1.420 - 18.114) and diabetes (OR 2.652, 95%CI 1.123 - 6.260). Stroke after the operations was found in 8 of 108 study patients and included cerebral infarction in 6 and transient ischemic attack in 2. 8 patients had late stroke (> 24 hours).
  
  
  CONCLUSIONS
  The elderly patients with previous stroke undergoing OPCABG are more likely to have neurologic injury after operations, these patients had longer stays in ICU and hospital.
authors: Department of Neurology, Anzhen Hospital of Capital University of Medical Sciences, Beijing 100029, China. Li_cao@hotmail.com
authors: Li
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