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Effect of Neurology Consults on Outcomes for Patients Suffering Transient Ischemic Attacks After Coronary Artery Bypass Grafting

University of California-San Francisco, Fresno, California

Maher Kali, MD

Department of Internal Medicine, West Virginia University-Charleston Division

William Carter, MD

Department of Internal Medicine, West Virginia University-Charleston Division

Kristi Lucas, PharmD

Charleston Area Medical Center, Health Education and Research Institute, Charleston, West Virginia

Shahana Masood, MD

Department of Internal Medicine, West Virginia University-Charleston Division

Rana Dawli, MD

Charleston Area Medical Center, Health Education and Research Institute, Charleston, West Virginia

Mike Broce, BA

Charleston Area Medical Center, Health Education and Research Institute, Charleston, West Virginia, mike.broce{at}camc.org

Bernardo Reyes, MD, CPI

Department of Internal Medicine, West Virginia University-Charleston Division, Charleston Area Medical Center, Health Education and Research Institute, Charleston, West Virginia

Stroke patients appear to have lower morbidity and mortality rates and better outcomes when neurologists serve as the primary admitting physician. The effect of neurological consultations on coronary artery bypass graft (CABG) patients who have suffered a postoperative transient ischemic attack (TIA) has not yet been determined. The authors evaluated whether neurology consultations improved outcomes. A retrospective analysis was conducted of CABG patients from a high-volume tertiary care center. Primary end points included 30-day mortality, discharge disposition, length of stay, and 1-year incidence of stroke. Post-CABG TIA patients receiving a neurological consult (N = 127) were compared with propensity-matched controls. Thirty-day mortality was identical (3.1%), with nonsignificant difference in long-term incidence of stroke. There were no differences in home discharges or length of stay. Including a neurologist in the treating team for patients suffering TIAs after CABG appears not to reduce post-operative incidence of morbidity and mortality, reduce length of stay, or improve patient disposition at discharge. (Am J Med Qual 2008;23:457-464)

Key Words: coronary artery bypass grafting (CABG) • neurologist • consultation • transient ischemic attack (TIA)

This version was published on November 1, 2008

American Journal of Medical Quality, Vol. 23, No. 6, 457-464 (2008)
DOI: 10.1177/1062860608324545


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