Impact of Neuromonitoring During Cardiac Procedures

Study Overview
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Brief Summary
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Through a series of sequential analyses, retrospective database exploration looking for linkages and associations between the use of processed electroencephalogram (EEG) and/or cerebral saturation monitoring and patient outcomes post-cardiothoracic surgery will be explored.

Detailed Description
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The purpose of this study is to mine the Premier Healthcare Database to: define the incidence of post-operative cognitive complications, acute kidney injury and stroke after specific cardiac surgical procedures (defined as: coronary artery bypass graft [CABG], Aortic Valve Replacement, Mitral valve repair, Mitral valve replacement, thoracic aortic operation, combined CABG and Valve replacement or repair ; and Determine the incremental increase in the length of hospitalization and cost of hospitalization among cardiac surgical patients who suffer postoperative cognitive complications, acute kidney injury and stroke; and Determine the effectiveness of intraoperative neuromonitoring with cerebral saturation and/or processed electroencephalogram (EEG) monitoring on the incidence of post-operative cognitive complications, acute kidney injury and stroke as a consequence of specific cardiac surgery procedures. The Premier Healthcare Database is a privately owned database that represents approximately 1/5th of all United States hospitalizations annually. It includes all International Classification of Diseases-9th Revision (ICD-9) and International Classification of Diseases-Clinical Modification (ICD-9-CM) diagnosis and procedure codes recorded by the hospital, as well as a limited set of Current Procedural Terminology (CPT)-4 codes. Within the database, discharge-level data include information on patient and provider characteristics, diagnoses and procedures, hospital resource utilization, and charges/cost data for all entries, including pharmacy charges.

Official Title
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Impact of Neuromonitoring During Cardiothoracic Procedures: A Retrospective Analysis

Conditions
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Delirium, Stroke, Acute Kidney Injury

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All adult (age >=18 years) hospitalized patients who underwent major cardiac surgical procedure requiring cardiopulmonary bypass captured in the premier database from January 1, 2010 - December 31, 2014 (5 year period) Exclusion Criteria: <18 years of age Cardiac procedures not requiring cardiopulmonary bypass

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 100 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Delirium: Incidence of post-operative cognitive complications identified by ICD-9 diagnosis code | Incidence of post-operative cognitive complications identified by International Classification of Disease (ICD-9) diagnosis code | 5 years | 
| Acute Kidney Injury: Incidence of acute kidney injury identified by ICD-9 diagnosis code | Incidence of acute kidney injury identified by ICD-9 diagnosis code | 5 years | 
| Stroke: Incidence of stroke identified by ICD-9 diagnosis code | Incidence of stroke identified by ICD-9 diagnosis code | 5 years |