Risk factors for ischemic optic neuropathy after cardiopulmonary bypass: Amatched case/control study

Citation
Ga. Nuttall et al., Risk factors for ischemic optic neuropathy after cardiopulmonary bypass: Amatched case/control study, ANESTH ANAL, 93(6), 2001, pp. 1410-1416
Citations number
32
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Aneshtesia & Intensive Care","Medical Research Diagnosis & Treatment
Journal title
ANESTHESIA AND ANALGESIA
ISSN journal
0003-2999 → ACNP
Volume
93
Issue
6
Year of publication
2001
Pages
1410 - 1416
Database
ISI
SICI code
0003-2999(200112)93:6<1410:RFFION>2.0.ZU;2-#
Abstract
Visual loss (acuity or field) secondary to ischemic optic neuropathy (ION) is a rare but devastating complication of cardiac surgery involving cardiop ulmonary bypass (CPB). We determined clinical features and risk factors for ION by a retrospective time-matched, case-control study. ION was identifie d in 17 (0.06%) patients out of 27,915 patients who underwent CPB between J anuary 1, 1976, and December 31, 1994. For each ION patient, two patients w ho underwent CPB exactly 2 wk before the ION patient were selected as contr ols. Data were analyzed by using conditional logistic regression with the 1 :2 matched-set feature of 17 cases and 34 controls. Two-tailed P values les s than or equal to0.05 were considered significant. From bivariate analysis , smaller minimum postoperative hemoglobin concentration (odds ratio [OR] = 1.9, P = 0.047) and the presence of atherosclerotic vascular disease (OR = 7.0, P = 0.026) were found to be independently associated with ION after C PB, as were smaller minimum postoperative hemoglobin concentration (OR = 2. 2, P = 0.027) and preoperative angiogram within 48 h of surgery (OR = 7.2, P = 0.042). In ION patients, 13 (76.5%) of 17 experienced a minimum postope rative hemoglobin value of <8.5 g/dL, whereas only 14 (41.2%) of 34 control patients experienced values <8.5 g/dL.