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Adverse cerebral outcomes occurred in 129 patients(6.1 percent).A total of 3.1 percent had type I neurologic outcomes(8 died of cerebral injury,55 had nonfatal strokes,2 had transient ischemic attacks,and 1 had stupor), and 3.0 percent had type II outcomes(55 had deterioration of intellectual function and 8 had seizures).Patients with adverse cerebral outcomes had higher in-hospital mortality(21 percent of patients with type I outcomes died,vs.10 percent of those with type II and 2 percent of those with no adverse cerebral outcome;P<0.001 for all comparisons),longer hospitalization(25 days with type I outcomes,21 days with type II,and 10 days with no adverse outcome;P<0.001),and a higher rate or discharge to facilities for intermediate-or long-term care(47 percent,30 percent,and 8 percent;P<0.001).Predictors of type I outcomes were proximal aortic atherosclerosis,a history of neurologic diseases,and older age;predictors of type II outcomes were older age,systolic hypertension on admission, pulmonary disease,and excessive consumption of alcohol.Adverse cerebral outcomes after coronary bypass surgery are relatively common and serious, they are associated with substantial increases in mortality,length of hospitalization,and use of intermediate-or long-term care facilities.New diagnostic and therapeutic strategies must be developed to lessen such injury. |
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