Predictors of neurological morbidity after coronary artery bypass surgery

Objective: The aim of this study was to analyze the postoperative neurological complications after myocardial revascularization. Methods: We analyzed the pre-, peri- and postoperative data of 3834 patients who underwent a primary isolated bypass grafting between January 1987 and December 1995. Postoperative neurological complications (A) were divided into mild complications (B) and major complications (C). Results: The incidence of A increased, from 1.4% to 3.0%. Unifactor risk analysis identified: age>75 years, peripheral vascular atherosclerosis, neurological pathology, aorta-pathology and perioperative myocardial infarction as risk factors for A. Perioperative myocardial infarction and neurological pathology for B; age>75 years, peripheral vascular atherosclerosis, neurological pathology, perioperative myocardial infarction and aorta pathology for C. Multifactor risk regression analysis identified peripheral vascular atherosclerosis, neurological pathology, aorta-pathology, perioperative myocardial infarction and the time cohort 1993–1995 as independent predictors for A; perioperative myocardial infarction and the time cohort 1993–1995 for B; neurological pathology, aorta-pathology and perioperative myocardial infarction for C. Conclusions: Peripheral vascular atherosclerosis, neurological pathology, aorta-pathology, the occurrence of a perioperative myocardial infarction and the time cohort 1993–1995 are identified as independent risk factors for neurological complications.