Impact of Neuromonitoring During Cardiac Procedures

The purpose of this study is to mine the Premier Healthcare Database to:

1. 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

2. 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

3. 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.

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