COMPARISON OF NEUROLOGICAL OUTCOMES BETWEEN ON-PUMP AND OFF-PUMP CORONARY ARTERY BY-PASS GRAFT SURGERY

Abstract

Objective: The objective of the study was to compare early postoperative neurological complications between on-pump and off-pump coronary artery bypass graft (CABG) surgery and to determine predictors of postoperative neurological complications. Methods: The present study is a comparative observational study which was performed in the Department of Cardiac Surgery, Punjab Institute of Cardiology, Lahore from 13 February 2026 to 13 May 2026. Through non probability consecutive sampling, a total of 182 adult patients who were undergoing isolated CABG were equally distributed in both groups (on-pump and off-pump). Clinical, operative and postoperative data was taken. The early neurological complications in the hospital environment were evaluated. Data were analyzed by SPSS and multivariable logistic regression was used to determine independent predictors. Results: The mean age was 56.8 ± 8.9 years, and 136 (74.7%) patients were male. Overall, neurological complications occurred in 20 (11.0%) patients. These were significantly more frequent after on-pump CABG than off-pump CABG, 15 (16.5%) versus 5 (5.5%), respectively. On multivariable analysis, age ≥60 years, on-pump CABG, postoperative atrial fibrillation, and mechanical ventilation >12 hours were independent predictors. Conclusion: Early neurological complications were more common after on-pump CABG. Careful patient selection, neurological surveillance, and rhythm monitoring may help reduce postoperative neurological morbidity.