title: Assesment of CABDEAL score as predictor of neurological dysfunction after on-pump coronary artery bypass grafting surgery.
abstract: BACKGROUND
  Neurological dysfunction is a feared postoperative morbidity of cardiac surgery, an important cause of death and increased spending in hospitals. Its prediction, however, is still uncertain.
  
  
  OBJECTIVE
  To assess the applicability of a preoperative score as a predictor of neurological dysfunction after coronary artery bypass grafting (CABG) under cardiopulmonary bypass (CPB).
  
  
  METHODS
  Prospective study that evaluated 77 patients who underwent CABG from February to October 2011. Using the score CABDEAL (creatinine, age, body mass index, diabetes, emergency surgery, abnormality on ECG, lung disease), patients were grouped into high (CABDEAL > 4) and low risk (CABDEAL<4). The predictive value of the score was compared with intraoperative and postoperative variables (aortic clamping time, CPB and ventilation time) as predictors of encephalopathy and stroke. Data were analyzed with descriptive statistics and compared with the Fisher exact test. ROC curve analysis was performed to evaluate the accuracy of the model for the neurological outcomes. It was considered the significant value P<0.05.
  
  
  RESULTS
  The mortality rate was 2.6% (n=2). There were 2 episodes of stroke (2.6%) and 12 (15.5%) of encephalopathy. High risk CABDEAL (P=0.0009), ventilation time (P=0.014), CPB time (P=0.02) and aortic clamping time (P=0.006) were significantly associated with encephalopathy. The aortic clamping time was also associated with stroke (P=0.03) and death (P=0.006). CABDEAL score showed the largest area under the ROC curve rather than others variables.
  
  
  CONCLUSIONS
  In this study, the CABDEAL score stood out as the best predictor of encephalopathy after CABG when compared to the others intraoperative variables.
authors.affiliation: Serviço de Cirurgia Cardíaca, Hospital Universitário, Universidade Federal do Maranhão, São Luís, MA, Brasil. rvnina@terra.com.br
authors.forename: Vinícius José da Silva
authors.initials: VJ
authors.lastname: Nina
authors.forename: Maria Iracema de Amorim
authors.initials: MI
authors.lastname: Rocha
authors.forename: Rayssa Fiterman
authors.initials: RF
authors.lastname: Rodrigues
authors.forename: Vanessa Carvalho de
authors.initials: VC
authors.lastname: Oliveira
authors.forename: João Lívio Linhares
authors.initials: JL
authors.lastname: Teixeira
authors.forename: Eduardo Durans
authors.initials: ED
authors.lastname: Figueredo
authors.forename: Rachel Vilela de Abreu Haickel
authors.initials: RV
authors.lastname: Nina
authors.forename: Carlos Antonio Coimbra
authors.initials: CA
authors.lastname: Sousa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001011:Aorta / Q000601:surgery; D001927:Brain Diseases / Q000209:etiology* / Q000401:mortality; D003250:Constriction; D001026:Coronary Artery Bypass / Q000009:adverse effects* / Q000401:mortality; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012016:Reference Values; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000209:etiology / Q000401:mortality