Key result
The absence of intraoperative cerebral oximetry monitoring during open-heart surgery was associated with a significantly higher risk of mortality (OR 20.51) compared to protocolized monitoring.
Why the study?
Cardiothoracic surgeries often result in complications, and the association of intraoperative cerebral oxygen monitoring with postoperative complications needed evaluation.
Does protocolized intraoperative cerebral oximetry monitoring reduce postoperative complications in high-risk adult patients undergoing open-heart surgery?
Case-Control (n=647)
No
Does protocolized intraoperative cerebral oximetry monitoring reduce postoperative complications in high-risk adult patients undergoing open-heart surgery?
Odds Ratio: 20.51 (95% CI 3.32–126.64)
Absolute Event Rate: 7.9% vs 28.7%
p-value: p=<0.001
Protocolized intraoperative cerebral oximetry monitoring during open-heart surgery in high-risk patients is associated with significantly lower odds of postoperative stroke, renal failure requiring dialysis, and mortality.
May support cerebral oximetry monitoring in open-heart surgery; hypothesis-generating and should not change practice without RCTs.
Cardiothoracic surgeries are life-saving procedures but often it results in various complications. Intraoperative cerebral oximetry monitoring used to detect regional cerebral oxygen saturation (rScO2) is a non-invasive method that provides prognostic importance in cardiac surgery. The main aim of the present study was to evaluate the association of intraoperative cerebral oxygen monitoring during cardiac surgery on postoperative complications. This was a case-controlled retrospective study conducted on adult patients, who underwent open-heart surgery in National Heart Institute, Malaysia. The case group comprised patients on protocolized cerebral oximetry monitoring. They were treated using a standardized algorithm to maintain rScO2 not lower than 20% of baseline rScO2. The control group comprised patients with matched demographic background, preoperative risk factors, and type of surgical procedures. Propensity score stratification was utilized to contend with selection bias. Retrospective analysis was performed on 240 patients (case group) while comparing it to 407 patients (control group). The non-availability of cerebral oximetry monitoring during surgery was the prominent predictor for all outcome of complications; stroke (OR: 7.66), renal failure needing dialysis (OR: 5.12) and mortality (OR: 20.51). Postoperative complications revealed that there were significant differences for risk of mortality (p<0.001, OR = 20.51), renal failure that required dialysis (p<0.001, OR = 5.12) and stroke (p <0.05, OR = 7.66). Protocolized cerebral oximetry monitoring during cardiothoracic surgeries was found to be associated with lower incidence of stroke, renal failure requiring dialysis and mortality rate.
No takes yet. Share an insight, caveat, or question.
Juliana et al. (2021) conducted a case-control in Open-heart surgery (n=647). Intraoperative cerebral oximetry monitoring vs. No cerebral oximetry monitoring was evaluated on Mortality (OR 20.51, 95% CI 3.32-126.64, p=<0.001). The absence of intraoperative cerebral oximetry monitoring during open-heart surgery was associated with a significantly higher risk of mortality (OR 20.51) compared to protocolized monitoring.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: