Cognitive Dysfunction after Off-pump versus On-pump Coronary Artery Bypass Surgery: a Meta-analysis

OBJECTIVE: A meta-analysis to compare the incidence of postoperative cognitive dysfunction (POCD) following off-pump coronary artery bypass grafting (OPCAB) versus after conventional coronary artery bypass grafting (CABG). METHODS: A systematic search of the Medline, EMBASE(R) and Cochrane Library databases was performed to identify randomized controlled trials published until the end of November 2011. Data were analysed using RevMan version 5.0 software. RESULTS: The literature search identified 13 randomized controlled trials which included a total of 2326 cases. Meta-analysis found that the incidence of POCD was significantly higher following CABG than after OPCAB during the perioperative period (1 - 2 weeks) and at 3 months postsurgery. There were no significant between-group differences at 6 or 12 months postsurgery. CONCLUSIONS: Compared with CABG, OPCAB was found to be associated with a reduced incidence of early-stage POCD. Caution must be taken when interpreting these findings because of limitations in the available data.