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

Gregory A. Nuttall, James A. Garrity, Joseph A. Dearani, Martin D. Abel, Darrell R. Schroeder, Charles J. Mullany

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Abstract

Visual loss (acuity or field) secondary to ischemic optic neuropathy (ION) is a rare but devastating complication of cardiac surgery involving cardiopulmonary bypass (CPB). We determined clinical features and risk factors for ION by a retrospective time-matched, case-control study. ION was identified in 17 (0.06%) patients out of 27,915 patients who underwent CPB between January 1, 1976, and December 31, 1994. For each ION patient, two patients who underwent CPB exactly 2 wk before the ION patient were selected as controls. 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 ≤0.05 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 CPB, 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 postoperative hemoglobin value of <8.5 g/dL, whereas only 14 (41.2%) of 34 control patients experienced values <8.5 g/dL.

Original languageEnglish (US)
Pages (from-to)1410-1416
Number of pages7
JournalAnesthesia and analgesia
Volume93
Issue number6
DOIs
StatePublished - Jan 1 2001

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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    Nuttall, G. A., Garrity, J. A., Dearani, J. A., Abel, M. D., Schroeder, D. R., & Mullany, C. J. (2001). Risk factors for ischemic optic neuropathy after cardiopulmonary bypass: A matched case/control study. Anesthesia and analgesia, 93(6), 1410-1416. https://doi.org/10.1097/00000539-200112000-00012