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Risk factors for ischemic optic neuropathy after cardiopulmonary bypass: a matched case/control study.
G A Nuttall1, J A Garrity, J A Dearani
1Department of Anesthesiology, Mayo Graduate School of Medicine, Rochester, Minnesota 55905, USA. nuttall.gregory@mayo.edu
Anesthesia and Analgesia
|December 1, 2001
Summary
Ischemic optic neuropathy (ION) after cardiac surgery is rare. Risk factors include atherosclerotic vascular disease, preoperative angiograms, and low postoperative hemoglobin levels, particularly below 8.5 g/dL.
Area of Science:
- Ophthalmology
- Cardiovascular Surgery
Background:
- Ischemic optic neuropathy (ION) is a rare but severe complication following cardiac surgery with cardiopulmonary bypass (CPB).
- Understanding risk factors is crucial for preventing vision loss in these patients.
Purpose of the Study:
- To identify clinical features and risk factors associated with ION after CPB.
- To determine the incidence of ION in patients undergoing CPB.
Main Methods:
- A retrospective, time-matched, case-control study was conducted.
- 17 ION patients were compared with 34 control patients who underwent CPB.
- Conditional logistic regression was used for data analysis.
Main Results:
- The incidence of ION was 0.06% (17 out of 27,915 patients).
- Independent risk factors for ION included atherosclerotic vascular disease (OR=7.0) and preoperative angiogram within 48 hours (OR=7.2).
- Lower minimum postoperative hemoglobin (<8.5 g/dL) was significantly associated with ION (OR=1.9-2.2).
Conclusions:
- Patients with a history of vascular disease or recent preoperative angiograms are at higher risk for ION post-cardiac surgery.
- Maintaining adequate postoperative hemoglobin levels is critical for mitigating ION risk.
