In this cohort of 225 patients undergoing CABG or valve surgery, they were assessed with a mini-mental status exam (MMSE) and Confusion Assessment Method (CAM) preoperatively, daily from postoperative day 2 to discharge, and at 1, 6, and 12 months. Almost half (46%) developed delirium. At 6 months, the proportion of those that had not returned to baseline MMSE was significantly higher in those with delirium compared to those without (40% vs 24). Delirium prevention may improve long term cognitive function after cardiac surgery (abstract)
In this large multicenter trial, patients with minor stroke or TIA were randomized to clopidogrel+ASA or ASA alone; 90-day stroke occurred in 8% vs 12% respectively, and rates of hemorrhage or hemorrhagic stroke were the same (abstract).
These guidelines provide an evidence based for the use of periprocedural antithrombotics in patients with cerebrovascular disease. They recommend continuing ASA-warfarin for dental procedures, and most other minor procedures. There is little evidence to support the use of procedural bridging with heparin, and it does increase the risk of bleeding. Cessation of therapy for 7 […]
A large analysis from a stroke registry found better outcomes with earlier thrombolytics for acute ischemic stroke; every 15 minutes earlier was associated with an odds ratio of 0.96 for in-hospital death or intracranial hemorrhage, and an odds ratio of 1.03 for being discharged home and 1.04 for walking independently at discharge (abstract).